Healthcare Provider Details

I. General information

NPI: 1467434761
Provider Name (Legal Business Name): MOSES TAYLOR HOME HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 01/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 QUINCY AVE
SCRANTON PA
18510-1724
US

IV. Provider business mailing address

700 QUINCY AVE
SCRANTON PA
18510-1724
US

V. Phone/Fax

Practice location:
  • Phone: 570-340-2700
  • Fax: 570-340-2799
Mailing address:
  • Phone: 570-340-2700
  • Fax: 570-340-2799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number761105
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier20007793
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerAMERIHEALTH MERCY
# 2
Identifier397611
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerBLUE CROSS INSURANCE
# 3
Identifier810114
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerFIRST PRIORITY HEALTH
# 4
Identifier2Y5765
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHEALTH NET INSURANCE
# 5
Identifier000000025175
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerMED PLUS THREE RIVERS
# 6
Identifier75877800
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerFEDERAL BLACK LUNG
# 7
Identifier1007771410018
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 8
Identifier2329840
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerAETNA INSURANCE
# 9
Identifier43016
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerGEISINGER HEALTH PLAN

VIII. Authorized Official

Name: MR. WILLIAM ROE
Title or Position: VP FINANCE
Credential:
Phone: 570-340-2991