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General NPI Number Information
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NPI Number | 1154804813
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Entity Type | Organization
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Legal Business Name | PRIME HOME CARE, INC
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Dates
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Enumeration Date | 09/10/2018
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 9735 BUSTLETON AVE SUITE 2N
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City | PHILADELPHIA
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State | PA
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Zip | 19115-1109
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Country | US
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Telephone | 800-515-0526
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Fax | 800-905-7584
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Provider Business Mailing Address
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Address Line | 9735 BUSTLETON AVE SUITE 2N
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City | PHILADELPHIA
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State | PA
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Zip | 19115
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Country | US
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Telephone | 800-515-0526
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Fax | 800-905-7584
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Authorized Official
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Title or Position | PRESIDENT
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Name | ARK LIBKIND
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Credential |
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Telephone | 267-872-5440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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