MEDICARE: NOBLE HEARTS HOME CARE 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	374U00000X	Home Health Aide	38053601	PA
2	3416L0300X	Land Ambulance

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	38053601	OTHER	PA	LICENSE #

General Provider Information

NPI Number	:	1669951810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOBLE HEARTS HOME CARE LLC

Provider Business Mailing Address
First Line	:	6232 RIDGE AVE # 1
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19128-2631
Country	:	US
Telephone Number	:	267-235-4044
Fax Number	:

Provider Business Practice Location Address
First Line	:	6232 RIDGE AVE # 1
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19128-2631
Country	:	US
Telephone Number	:	267-235-4044
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. CHANEL CHIQUITA BROWN
Credential	:
Telephone Number	:	267-235-4044

Provider Enumeration Date	:	08/08/2018
Last Update Date	:	12/06/2021

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Directions to “NOBLE HEARTS HOME CARE LLC ” Practice Location

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