Healthcare Provider Details

I. General information

NPI: 1497759971
Provider Name (Legal Business Name): TOTAL HOME HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 12/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

437 MAIN ST
STROUDSBURG PA
18360-2597
US

IV. Provider business mailing address

437 MAIN ST
STROUDSBURG PA
18360-2597
US

V. Phone/Fax

Practice location:
  • Phone: 570-421-1110
  • Fax: 570-421-1207
Mailing address:
  • Phone: 570-421-1110
  • Fax: 570-421-1207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP414088L
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: VICTOR HELLSTROM
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 570-421-1110