MEDICARE: HOME NURSING AGENCY COMMUNITY SERVICES

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	15283601	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

General Provider Information

NPI Number	:	1730250689
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME NURSING AGENCY COMMUNITY SERVICES

Provider Business Mailing Address
First Line	:	201 CHESTNUT AVE
Second Line	:	PRIVATE DUTY
City	:	ALTOONA
State	:	PA
Zip	:	16601-4927
Country	:	US
Telephone Number	:	814-946-5411
Fax Number	:	814-942-1673

Provider Business Practice Location Address
First Line	:	1216 PLEASANT VALLEY BOULEVARD
Second Line	:	SUITE 208 - PRIVATE DUTY
City	:	ALTOONA
State	:	PA
Zip	:	16602-4750
Country	:	US
Telephone Number	:	814-946-5411
Fax Number	:	814-940-8471

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PHILIP L FREEMAN
Credential	:
Telephone Number	:	814-946-5411

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	04/24/2015

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