MEDICARE: ENURZEN 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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1265272124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENURZEN LLC

Provider Business Mailing Address
First Line	:	5247 N 15TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19141-1601
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4548 MARKET ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19139-3610
Country	:	US
Telephone Number	:	267-394-0332
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	RAY L WALL
Credential	:
Telephone Number	:	267-394-0332

Provider Enumeration Date	:	05/29/2024
Last Update Date	:	01/09/2025

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Directions to “ENURZEN LLC ” Practice Location

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