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General NPI Number Information
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NPI Number | 1770028177
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Entity Type | Organization
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Legal Business Name | MEDI-HOME HEALTHCARE AGENCY
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Dates
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Enumeration Date | 12/21/2016
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Last Update Date | 12/21/2016
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Provider Practice Location Address
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Address Line | 5716 N CAMAC ST
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City | PHILADELPHIA
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State | PA
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Zip | 19141-4108
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Country | US
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Telephone | 267-761-1630
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Fax | 267-217-1060
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Provider Business Mailing Address
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Address Line | 5716 N CAMAC ST
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City | PHILADELPHIA
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State | PA
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Zip | 19141-4108
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Country | US
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Telephone | 267-761-1630
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Fax | 267-217-1060
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. RILMA J SCOTT-LEWIS
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Credential | RN, MSN
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Telephone | 267-761-1630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 32083601
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License Number State | PA
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