NPI Code Details Logo

NPI 1275280463

NPI 1275280463 : EMINENT CARE LLC : PHILADELPHIA, PA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1275280463
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    EMINENT CARE LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    03/07/2022
-----------------------------------------------------
    Last Update Date     |    03/07/2022
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1946 74TH AVE 
-----------------------------------------------------
    City                 |    PHILADELPHIA
-----------------------------------------------------
    State                |    PA
-----------------------------------------------------
    Zip                  |    19138-2221
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    267-438-6135
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1946 74TH AVE 
-----------------------------------------------------
    City                 |    PHILADELPHIA
-----------------------------------------------------
    State                |    PA
-----------------------------------------------------
    Zip                  |    19138-2221
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    267-438-6135
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER/ADMINISTRATOR
-----------------------------------------------------
    Name                 |     DEJAH  GRIFFIN-PARRISH 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    267-438-6135
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    253Z00000X
-----------------------------------------------------
    Taxonomy Name        |    In Home Supportive Care Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.