MEDICARE: HOMECARE OF PENNSYLVANIA

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	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PA126303	OTHER	PA	HOME IMPROVEMENT CONTRACTOR

General Provider Information

NPI Number	:	1679023543
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMECARE OF PENNSYLVANIA

Provider Business Mailing Address
First Line	:	239 MAIN ST STE 301
Second Line	:
City	:	DICKSON CITY
State	:	PA
Zip	:	18519-1653
Country	:	US
Telephone Number	:	570-780-8276
Fax Number	:

Provider Business Practice Location Address
First Line	:	239 MAIN ST STE 301
Second Line	:
City	:	DICKSON CITY
State	:	PA
Zip	:	18519-1653
Country	:	US
Telephone Number	:	570-780-8276
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. WILLIAM SHOENER
Credential	:
Telephone Number	:	570-780-8276

Provider Enumeration Date	:	10/04/2016
Last Update Date	:	10/04/2016

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Directions to “HOMECARE OF PENNSYLVANIA ” Practice Location

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