Healthcare Provider Details

I. General information

NPI: 1477732816
Provider Name (Legal Business Name): CASMIR CARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 08/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 N 35TH ST
PHILADELPHIA PA
19104-1901
US

IV. Provider business mailing address

619 N 35TH ST
PHILADELPHIA PA
19104-1901
US

V. Phone/Fax

Practice location:
  • Phone: 267-241-4676
  • Fax: 215-382-6244
Mailing address:
  • Phone: 267-241-4676
  • Fax: 215-382-6244

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 Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StatePA

VIII. Authorized Official

Name: MRS. CHETACHI ECTON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 267-241-4676