MEDICARE: ABRAHAM HOME CARE SERVICES 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	22353601	PA

General Provider Information

NPI Number	:	1356749295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABRAHAM HOME CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	1735 MARKET ST
Second Line	:	SUITE 3750
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-7501
Country	:	US
Telephone Number	:	410-258-9844
Fax Number	:

Provider Business Practice Location Address
First Line	:	1735 MARKET ST
Second Line	:	SUITE 3750
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-7501
Country	:	US
Telephone Number	:	410-258-9844
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ABIODUN ONABIYI
Credential	:
Telephone Number	:	410-258-9844

Provider Enumeration Date	:	12/09/2014
Last Update Date	:	12/10/2014

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