=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669759494
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOME CHOICE COMPANION CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/08/2011
-----------------------------------------------------
Last Update Date | 11/08/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 212 W MAIN ST
-----------------------------------------------------
City | TRAPPE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19426-2062
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-454-0855
-----------------------------------------------------
Fax | 610-454-0981
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 212 W MAIN ST
-----------------------------------------------------
City | TRAPPE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19426-2062
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-454-0855
-----------------------------------------------------
Fax | 610-454-0981
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. MICHAEL ZERBATO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 610-454-0855
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 17913601
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------