Healthcare Provider Details

I. General information

NPI: 1013600204
Provider Name (Legal Business Name): 215 HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2023
Last Update Date: 06/01/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8110 W CHESTER PIKE FL 2
UPPER DARBY PA
19082-2828
US

IV. Provider business mailing address

8110 W CHESTER PIKE FL 2
UPPER DARBY PA
19082-2828
US

V. Phone/Fax

Practice location:
  • Phone: 215-544-2000
  • Fax: 215-948-7775
Mailing address:
  • Phone: 215-544-2000
  • Fax: 215-948-7775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GREATER NYAMAYARO
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 215-544-2000