MEDICARE: PRECIOUS CARE AT HOME SERVICES 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	251E00000X	Home Health Agency	05520501	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	1194901496	OTHER	VA	HOME CARE

General Provider Information

NPI Number	:	1730578980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECIOUS CARE AT HOME SERVICES INC

Provider Business Mailing Address
First Line	:	1735 MARKET ST
Second Line	:	SUITE 3750
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-7501
Country	:	US
Telephone Number	:	267-507-6156
Fax Number	:	267-507-6150

Provider Business Practice Location Address
First Line	:	1735 MARKET ST
Second Line	:	SUITE 3750
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-7501
Country	:	US
Telephone Number	:	267-507-6156
Fax Number	:	267-507-6150

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. NAILEY COLE
Credential	:	RN
Telephone Number	:	703-425-2273

Provider Enumeration Date	:	01/12/2015
Last Update Date	:	01/12/2015

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