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General NPI Number Information
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NPI Number | 1588035471
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Entity Type | Organization
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Legal Business Name | GREATER HOMECARE SERVICES INC.
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Dates
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Enumeration Date | 10/17/2015
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Last Update Date | 10/17/2015
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Provider Practice Location Address
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Address Line | 8110 W CHESTER PIKE
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City | UPPER DARBY
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State | PA
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Zip | 19082-2828
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Country | US
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Telephone | 484-452-8042
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Fax | 484-452-8043
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Provider Business Mailing Address
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Address Line | 8110 W CHESTER PIKE
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City | UPPER DARBY
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State | PA
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Zip | 19082-2828
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Country | US
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Telephone | 484-452-8042
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Fax | 484-452-8043
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. TEBOHO L MATHUTHU
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Credential | RN, BS
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Telephone | 267-296-0076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 28893601
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License Number State | PA
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