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NPI Code Detail

MEDICARE: TENDEDR LOVING CARE HEALTH CARE SERVICES OF PA, LLC

MEDICARE: TENDEDR LOVING CARE HEALTH CARE SERVICES OF PA, 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 Agency756705PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
130022841OTHERPAPA KEYSTONE MERCY HEALTH
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215981394
Entity Type Code : Organization
Provider Name (Legal Business Name) : TENDEDR LOVING CARE HEALTH CARE SERVICES OF PA, LLC
Provider Business Mailing Address
First Line : 1983 MARCUS AVE
Second Line : STE 200
City : LAKE SUCCESS
State : NY
Zip : 11042-1016
Country : US
Telephone Number : 516-358-1000
Fax Number : 516-327-8636
Provider Business Practice Location Address
First Line : 401 COMMERCE DR
Second Line : 2ND FL
City : FT WASHINGTON
State : PA
Zip : 19034-2714
Country : US
Telephone Number : 215-646-9401
Fax Number : 215-646-9543
Authorized Official
Title or Position : CFO
Name : WILLARD T DERR
Credential :
Telephone Number : 516-358-1000
Provider Enumeration Date : 05/21/2006
Last Update Date : 07/19/2007

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Directions to “TENDEDR LOVING CARE HEALTH CARE SERVICES OF PA, LLC ” Practice Location

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