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General NPI Number Information
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NPI Number | 1629587498
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Entity Type | Organization
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Legal Business Name | KORMI HEALTH SERVICES LLC
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Dates
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Enumeration Date | 09/25/2017
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Last Update Date | 09/25/2017
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Provider Practice Location Address
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Address Line | 23 MELROSE AVE
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City | EAST LANSDOWNE
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State | PA
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Zip | 19050-2527
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Country | US
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Telephone | 484-273-9366
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Fax |
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Provider Business Mailing Address
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Address Line | 23 MELROSE AVE
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City | EAST LANSDOWNE
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State | PA
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Zip | 19050-2527
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RN
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Name | KORTO GOLOWO
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Credential |
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Telephone | 313-467-6604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 34113601
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License Number State | PA
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