=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306060124
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PENN STAFFING SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/12/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1218 CHESTNUT ST SUITE 305
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19107-4825
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-925-3980
-----------------------------------------------------
Fax | 215-925-3981
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1218 CHESTNUT ST SUITE 305
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19107-4825
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-925-3980
-----------------------------------------------------
Fax | 215-925-3981
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT PENN STAFFING SERVICES
-----------------------------------------------------
Name | MR. ARIF DEAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 215-744-1663
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------