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NPI Code Detail

MEDICARE: IMMEDIATE HOME CARE LLC

MEDICARE: IMMEDIATE HOME CARE LLC
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
1251E00000XHome Health Agency765005PA

General Provider Information

NPI Number : 1124029467
Entity Type Code : Organization
Provider Name (Legal Business Name) : IMMEDIATE HOME CARE LLC
Provider Business Mailing Address
First Line : 3901 MARKET ST STE 4B
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-3133
Country : US
Telephone Number : 215-638-2223
Fax Number :
Provider Business Practice Location Address
First Line : 3901 MARKET ST STE 4B
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-3133
Country : US
Telephone Number : 215-638-2223
Fax Number :
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : MS. MARI WILLIS
Credential :
Telephone Number : 216-970-1189
Provider Enumeration Date : 08/09/2005
Last Update Date : 08/14/2024

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Directions to “IMMEDIATE HOME CARE LLC ” Practice Location

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