=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437515699
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THOMPSON HEALTH CARE SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/04/2016
-----------------------------------------------------
Last Update Date | 01/04/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4940 PENN ST SUIT 3
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19124-2895
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-303-0852
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1009 BEAVER ST SUIT B
-----------------------------------------------------
City | BRISTOL
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19007-3231
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-303-0852
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/MEMBER
-----------------------------------------------------
Name | MS. ARAINA D THOMPSON
-----------------------------------------------------
Credential | LPN
-----------------------------------------------------
Telephone | 215-303-0852
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | PN258626L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------