Healthcare Provider Details

I. General information

NPI: 1609240258
Provider Name (Legal Business Name): LOLLIPOP HOME HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2015
Last Update Date: 04/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 N FRONT ST
SUNBURY PA
17801-1810
US

IV. Provider business mailing address

204 N FRONT ST
SUNBURY PA
17801-1810
US

V. Phone/Fax

Practice location:
  • Phone: 570-286-9460
  • Fax:
Mailing address:
  • Phone: 570-286-9460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State

VIII. Authorized Official

Name: LAURA SHRAWDER-MILES
Title or Position: OWNER
Credential:
Phone: 570-286-9460