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General NPI Number Information
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NPI Number | 1114366184
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Entity Type | Organization
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Legal Business Name | SACKO SERVICES
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Dates
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Enumeration Date | 06/22/2013
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Last Update Date | 01/07/2016
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Provider Practice Location Address
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Address Line | 1300 W JEFFERSON ST SUITE B
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City | PHILADELPHIA
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State | PA
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Zip | 19122-3326
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Country | US
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Telephone | 215-560-8893
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Fax | 215-644-9043
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Provider Business Mailing Address
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Address Line | 1300 W JEFFERSON ST SUITE B
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City | PHILADELPHIA
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State | PA
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Zip | 19122-3326
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Country | US
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Telephone | 215-560-8893
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Fax | 215-644-9043
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | SALOUM SACKO
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Credential |
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Telephone | 267-258-4779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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