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General NPI Number Information
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NPI Number | 1760836456
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Entity Type | Organization
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Legal Business Name | OUR HEART HOME CARE
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Dates
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Enumeration Date | 04/19/2016
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Last Update Date | 06/03/2021
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Provider Practice Location Address
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Address Line | 2250 RIDGE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19121-2930
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Country | US
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Telephone | 215-309-3885
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Fax |
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Provider Business Mailing Address
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Address Line | 62 CEDAR HILL LN
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City | MEDIA
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State | PA
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Zip | 19063-6311
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Country | US
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Telephone | 215-309-3885
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SURINDERPAL SINGH GILL
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Credential |
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Telephone | 215-309-3885
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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 | 30103601
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License Number State | PA
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