MEDICARE: CPGEL 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
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1306472162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CPGEL CARE, LLC

Provider Business Mailing Address
First Line	:	1699 E MARKET ST
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17403-1258
Country	:	US
Telephone Number	:	717-757-2273
Fax Number	:	717-326-1013

Provider Business Practice Location Address
First Line	:	1699 E MARKET ST
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17403-1258
Country	:	US
Telephone Number	:	717-757-2273
Fax Number	:	717-326-1013

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PAUL BRADY
Credential	:
Telephone Number	:	717-757-2273

Provider Enumeration Date	:	03/12/2020
Last Update Date	:	03/12/2020

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