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General NPI Number Information
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NPI Number | 1417707522
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Entity Type | Organization
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Legal Business Name | PENNELOPHYS HOME CARE, LLC
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Dates
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Enumeration Date | 03/25/2024
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Last Update Date | 03/25/2024
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Provider Practice Location Address
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Address Line | 32 N WASHINGTON ST STE 11B
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City | YPSILANTI
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State | MI
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Zip | 48197-2662
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Country | US
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Telephone | 734-274-1914
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Fax |
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Provider Business Mailing Address
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Address Line | 32 N WASHINGTON ST STE 11B
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City | YPSILANTI
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State | MI
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Zip | 48197-2662
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PENNELOPHY BOWMAN
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Credential |
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Telephone | 724-274-1914
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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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