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NPI Code Detail

MEDICARE: REVOLUTIONARY HOME HEALTH, INC.

MEDICARE: REVOLUTIONARY HOME HEALTH, 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
1251E00000XHome Health Agency02590501PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11795OTHERPAGEISINGER HEALTH PLAN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457359747
Entity Type Code : Organization
Provider Name (Legal Business Name) : REVOLUTIONARY HOME HEALTH, INC.
Provider Business Mailing Address
First Line : 829 SCRANTON CARBONDALE HWY
Second Line :
City : EYNON
State : PA
Zip : 18403-1020
Country : US
Telephone Number : 570-383-7502
Fax Number : 866-600-7413
Provider Business Practice Location Address
First Line : 829 SCRANTON CARBONDALE HWY
Second Line :
City : EYNON
State : PA
Zip : 18403-1020
Country : US
Telephone Number : 570-383-7502
Fax Number : 570-534-4225
Authorized Official
Title or Position : ADMINISTRATOR
Name : KATHLEEN EVANINA
Credential :
Telephone Number : 570-383-7502
Provider Enumeration Date : 07/11/2005
Last Update Date : 07/21/2020

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1841603164 — BRITTANY YERKES
Practice Location Address:
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18403-1020
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Practice Fax:
1639566557 — REVOLUTIONARY HOME HEALTH INC
Practice Location Address:
829 SCRANTON CARBONDALE HWY
EYNON, PA
18403-1020
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Practice Fax: 866-600-7413
1215459748 — CAITLIN HUNTER
Practice Location Address:
829 SCRANTON CARBONDALE HWY
EYNON, PA
18403-1020
Practice Phone: 570-383-7502
Practice Fax:
1578125944 — REVOLUTIONARY HOME HEALTH, INC.
Practice Location Address:
829 SCRANTON CARBONDALE HWY
EYNON, PA
18403-1020
Practice Phone: 570-383-7502
Practice Fax: 866-600-7413

Directions to “REVOLUTIONARY HOME HEALTH, INC. ” Practice Location

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