Healthcare Provider Details

I. General information

NPI: 1902040165
Provider Name (Legal Business Name): PD HOME CARE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2009
Last Update Date: 04/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 YOST BLVD SUITE 201
PITTSBURGH PA
15221-4864
US

IV. Provider business mailing address

103 YOST BLVD SUITE 201
PITTSBURGH PA
15221-4864
US

V. Phone/Fax

Practice location:
  • Phone: 412-816-0113
  • Fax: 412-816-0120
Mailing address:
  • Phone: 412-816-0113
  • Fax: 412-816-0120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: EMMA ACKER
Title or Position: GENERAL MANAGER
Credential:
Phone: 412-816-0113