MEDICARE: EPIPHANY HEALTHCARE SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251G00000X	Community Based Hospice Care Agency
2	385H00000X	Respite Care
3	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1477260479
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EPIPHANY HEALTHCARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	7648 WOODCREST AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19151-2705
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7648 WOODCREST AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19151-2705
Country	:	US
Telephone Number	:	215-668-1071
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	COURTNEY JACKSON
Credential	:
Telephone Number	:	215-668-1071

Provider Enumeration Date	:	10/31/2022
Last Update Date	:	10/31/2022

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