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General NPI Number Information
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NPI Number | 1851397012
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Entity Type | Organization
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Legal Business Name | PENN HOME HEALTH INC.
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 06/28/2019
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Provider Practice Location Address
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Address Line | 1480 INDIAN SPRINGS RD SUITE 3
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City | INDIANA
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State | PA
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Zip | 15701-3249
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Country | US
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Telephone | 724-465-0440
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Fax | 724-465-0444
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Provider Business Mailing Address
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Address Line | 1480 INDIAN SPRINGS RD SUITE 3
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City | INDIANA
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State | PA
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Zip | 15701-3249
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Country | US
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Telephone | 724-465-0440
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Fax | 724-465-0444
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | KEVIN CARTER DEYARMIN
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Credential |
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Telephone | 814-846-4160
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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 | 02360501
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License Number State | PA
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