MEDICARE: PHILADELPHIA HOME CARE AGENCY, INC

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	251E00000X	Home Health Agency		PA

General Provider Information

NPI Number	:	1194964981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHILADELPHIA HOME CARE AGENCY, INC

Provider Business Mailing Address
First Line	:	500 OLD YORK ROAD
Second Line	:	SUITE 105
City	:	JENKINTOWN
State	:	PA
Zip	:	19046-2852
Country	:	US
Telephone Number	:	215-947-8555
Fax Number	:	215-947-8557

Provider Business Practice Location Address
First Line	:	500 OLD YORK RD.
Second Line	:	SUITE 105
City	:	JENKINTOWN
State	:	PA
Zip	:	19046-2852
Country	:	US
Telephone Number	:	215-947-8555
Fax Number	:	215-947-8557

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MARINA DENTREMONT
Credential	:
Telephone Number	:	215-947-8555

Provider Enumeration Date	:	02/18/2009
Last Update Date	:	01/06/2026

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