Healthcare Provider Details

I. General information

NPI: 1912158932
Provider Name (Legal Business Name): IMMEDIATE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2008
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 MARKET ST STE 5
PHILADELPHIA PA
19104-3133
US

IV. Provider business mailing address

3901 MARKET ST STE 5
PHILADELPHIA PA
19104-3133
US

V. Phone/Fax

Practice location:
  • Phone: 215-638-2223
  • Fax:
Mailing address:
  • Phone: 215-638-2223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MARI WILLIS
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 216-970-1189