MEDICARE: HEART OF MARA HOMECARE 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	:	1609573914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART OF MARA HOMECARE LLC

Provider Business Mailing Address
First Line	:	7721 WALKER ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19136-3129
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7721 WALKER ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19136-3129
Country	:	US
Telephone Number	:	215-820-9677
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TAMARA BRUNSON
Credential	:
Telephone Number	:	215-820-9677

Provider Enumeration Date	:	02/08/2023
Last Update Date	:	02/08/2023

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