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General NPI Number Information
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NPI Number | 1811240211
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Entity Type | Organization
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Legal Business Name | NOVA HOME HEALTH CARE INC
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Dates
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Enumeration Date | 10/23/2012
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Last Update Date | 10/23/2012
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Provider Practice Location Address
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Address Line | 1211 VINE ST STE 111
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City | PHILADELPHIA
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State | PA
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Zip | 19107-1111
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Country | US
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Telephone | 215-864-0695
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Fax |
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Provider Business Mailing Address
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Address Line | 1211 VINE ST STE 111
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City | PHILADELPHIA
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State | PA
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Zip | 19107-1111
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Country | US
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Telephone | 215-864-0695
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAMED JAMA ABDI
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Credential | BS
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Telephone | 215-864-0695
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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 | 4139804
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License Number State | PA
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