MEDICARE: KP HOME HEALTHCARE 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	:	1750249116
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KP HOME HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	7748 JACKSON ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19136-3252
Country	:	US
Telephone Number	:	267-235-5270
Fax Number	:

Provider Business Practice Location Address
First Line	:	7748 JACKSON ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19136-3252
Country	:	US
Telephone Number	:	267-235-5270
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	WALEA T KOFA-PAYNE
Credential	:
Telephone Number	:	267-235-5270

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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