Healthcare Provider Details

I. General information

NPI: 1316943921
Provider Name (Legal Business Name): COMMUNITY HOME HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 12/09/2020
Certification Date: 12/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 E STREET RD
TREVOSE PA
19053-7711
US

IV. Provider business mailing address

351 E STREET RD
TREVOSE PA
19053-7711
US

V. Phone/Fax

Practice location:
  • Phone: 215-396-8252
  • Fax: 215-396-8253
Mailing address:
  • Phone: 215-396-8252
  • Fax: 215-396-8253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number39-7668
License Number StatePA

VIII. Authorized Official

Name: MS. LIN FUSARO
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 215-396-8252