Healthcare Provider Details

I. General information

NPI: 1912766874
Provider Name (Legal Business Name): REQUEST CONTRACTORS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2024
Last Update Date: 03/14/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 SWEENEY RD
SIMPSONVILLE SC
29680-7040
US

IV. Provider business mailing address

7601 CRITTENDEN ST APT H2
PHILADELPHIA PA
19118-3227
US

V. Phone/Fax

Practice location:
  • Phone: 267-446-4209
  • Fax:
Mailing address:
  • Phone: 267-446-4209
  • Fax:

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: MR. CHRIS SULLIVAN
Title or Position: OWNER
Credential:
Phone: 267-446-4209