MEDICARE: TOTAL HOME HEALTH CARE 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
1	3336C0004X	Compounding Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	333600000X	Pharmacy
4	3336C0003X	Community/Retail Pharmacy	PP414088L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2086650	OTHER		PK

General Provider Information

NPI Number	:	1497759971
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL HOME HEALTH CARE INC

Provider Business Mailing Address
First Line	:	437 MAIN ST
Second Line	:
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-2597
Country	:	US
Telephone Number	:	570-421-1110
Fax Number	:	570-421-1207

Provider Business Practice Location Address
First Line	:	437 MAIN ST
Second Line	:
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-2597
Country	:	US
Telephone Number	:	570-421-1110
Fax Number	:	570-421-1207

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	VICTOR HELLSTROM
Credential	:
Telephone Number	:	570-421-1110

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	12/07/2015

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