=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487675666
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAS HOME HEALTH CARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/22/2006
-----------------------------------------------------
Last Update Date | 05/02/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9200 MARSHALL ST
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19114
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-831-8008
-----------------------------------------------------
Fax | 215-831-1011
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9200 MARSHALL ST
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19114
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-831-8008
-----------------------------------------------------
Fax | 215-831-1011
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MS. BETTY J. BARNETTE
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 215-831-8008
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 02330501
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------