Healthcare Provider Details

I. General information

NPI: 1073549671
Provider Name (Legal Business Name): INFINITE CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 05/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6445 RISING SUN AVE
PHILADELPHIA PA
19111-5228
US

IV. Provider business mailing address

6445 RISING SUN AVE
PHILADELPHIA PA
19111-5228
US

V. Phone/Fax

Practice location:
  • Phone: 215-742-3247
  • Fax: 215-742-6199
Mailing address:
  • Phone: 215-742-3247
  • Fax: 215-742-6199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberRN335717L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number01980501
License Number StatePA

VIII. Authorized Official

Name: MR. LUIS LONDONO
Title or Position: PRESIDENT
Credential: RN
Phone: 215-742-3247