Healthcare Provider Details

I. General information

NPI: 1861615320
Provider Name (Legal Business Name): GENERALHEALTHCARE RESOURCES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 N WILTON ST
PHILADELPHIA PA
19139-1445
US

IV. Provider business mailing address

428 N WILTON STREET
PHILADELPHIA PA
19139-1445
US

V. Phone/Fax

Practice location:
  • Phone: 215-747-2705
  • Fax: 215-747-2705
Mailing address:
  • Phone: 215-747-2705
  • Fax: 215-747-2705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberPN096912L
License Number StatePA

VIII. Authorized Official

Name: MS. DEBBIE ANDERSON
Title or Position: NURSING DEPT
Credential:
Phone: 18008794471