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General NPI Number Information
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NPI Number | 1639103534
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Entity Type | Organization
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Legal Business Name | BERWICK HOME CARE SERVICES LLC
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 07/29/2020
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Provider Practice Location Address
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Address Line | 1409 N MARKET ST STE 201
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City | BERWICK
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State | PA
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Zip | 18603-2140
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Country | US
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Telephone | 570-520-4063
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Fax | 570-520-4214
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Provider Business Mailing Address
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Address Line | PO BOX 51266
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City | LAFAYETTE
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State | LA
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Zip | 70505-1266
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Country | US
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Telephone | 337-233-1307
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Fax | 337-233-5764
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Authorized Official
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Title or Position | TREASURER
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Name | JOSHUA L. PROFFITT
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Credential |
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Telephone | 337-233-1307
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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 | 727205
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License Number State | PA
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