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General NPI Number Information
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NPI Number | 1457579567
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Entity Type | Organization
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Legal Business Name | GENERAL HEATHCARE RESOURCE
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5014 MARKET ST
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City | PHILADELPHIA
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State | PA
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Zip | 19139-3504
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Country | US
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Telephone | 215-471-5856
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Fax |
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Provider Business Mailing Address
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Address Line | 5014 MARKET ST
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City | PHILADELPHIA
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State | PA
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Zip | 19139-3504
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Country | US
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Telephone | 215-471-5856
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Fax |
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Authorized Official
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Title or Position | CHEMOTHERAPY IV SPECIALIST
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Name | MS. HAVENS JENIEL LATISHA
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Credential |
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Telephone | 267-237-6661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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