Healthcare Provider Details

I. General information

NPI: 1588722813
Provider Name (Legal Business Name): MEADOWOOD CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 08/25/2022
Certification Date: 08/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3205 SKIPPACK PIKE
WORCESTER PA
19490-0670
US

IV. Provider business mailing address

3205 SKIPPACK PIKE PO BOX 670
WORCESTER PA
19490-0670
US

V. Phone/Fax

Practice location:
  • Phone: 610-584-3633
  • Fax: 610-584-3978
Mailing address:
  • Phone: 610-584-3633
  • Fax: 610-584-3978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number771105
License Number StatePA

VII. Legacy identifiers

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

VIII. Authorized Official

Name: MR. STEVEN WISNIEWSKI
Title or Position: CFO
Credential:
Phone: 610-584-1000