=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487411013
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BRENNAN HOME HEALTHCARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/29/2024
-----------------------------------------------------
Last Update Date | 02/29/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 32 OAKWOOD PL
-----------------------------------------------------
City | SWEDESBORO
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08085-1539
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-313-8432
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 32 OAKWOOD PL
-----------------------------------------------------
City | LOGAN TWP
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08085-1539
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-313-8432
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | CHRISTOPHER BRENNAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 856-313-8432
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174200000X
-----------------------------------------------------
Taxonomy Name | Meals Provider
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 177F00000X
-----------------------------------------------------
Taxonomy Name | Lodging Provider
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------