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General NPI Number Information
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NPI Number | 1821489774
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Entity Type | Organization
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Legal Business Name | BLOOMSBURG CAREGIVERS, LLC.
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Dates
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Enumeration Date | 02/13/2015
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Last Update Date | 02/13/2015
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Provider Practice Location Address
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Address Line | 240 MARKET ST
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City | BLOOMSBURG
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State | PA
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Zip | 17815-1770
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Country | US
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Telephone | 570-356-2420
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Fax |
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Provider Business Mailing Address
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Address Line | 240 MARKET ST
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City | BLOOMSBURG
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State | PA
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Zip | 17815-1770
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TRACEY SCHICKLEY
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Credential |
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Telephone | 570-356-2420
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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 | 26553601
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License Number State | PA
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