MEDICARE: TOTAL HOMECARE CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	0206008302	VA
2	335E00000X	Prosthetic/Orthotic Supplier
3	332BX2000X	Oxygen Equipment & Supplies (DME)	0206008302	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124021720
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL HOMECARE CORPORATION

Provider Business Mailing Address
First Line	:	555 E NORTH LN STE 5075
Second Line	:
City	:	CONSHOHOCKEN
State	:	PA
Zip	:	19428-2490
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3333 S CRATER RD
Second Line	:	STE 5
City	:	PETERSBURG
State	:	VA
Zip	:	23805
Country	:	US
Telephone Number	:	804-861-1606
Fax Number	:	804-862-1254

Authorized Official
Title or Position	:	CCO
Name	:	WENDY RUSSALESI
Credential	:
Telephone Number	:	484-246-9499

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	10/14/2025

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Directions to “TOTAL HOMECARE CORPORATION ” Practice Location

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