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General NPI Number Information
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NPI Number | 1730636507
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Entity Type | Organization
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Legal Business Name | CAMAHALODE, INC.
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 12/09/2016
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Provider Practice Location Address
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Address Line | 708 LAKESIDE PARK
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City | SOUTHAMPTON
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State | PA
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Zip | 18966-4020
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Country | US
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Telephone | 215-750-8802
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Fax |
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Provider Business Mailing Address
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Address Line | 80 SCHOOL LN
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City | NORRISTOWN
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State | PA
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Zip | 19403-3027
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Country | US
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Telephone | 215-696-0389
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. ERIC CARL SIERKA
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Credential |
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Telephone | 215-696-0389
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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 | 05310501
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 12993601
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License Number State | PA
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