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NPI Code Detail

MEDICARE: MAHONEY HOME HEALTHCARE SERVICES INC.

MEDICARE: MAHONEY HOME HEALTHCARE 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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1851562300
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAHONEY HOME HEALTHCARE SERVICES INC.
Provider Business Mailing Address
First Line : 9133 S STONY ISLAND AVE
Second Line : SUITE 2
City : CHICAGO
State : IL
Zip : 60617-3512
Country : US
Telephone Number : 773-375-9300
Fax Number : 773-375-9337
Provider Business Practice Location Address
First Line : 9133 S STONY ISLAND AVE
Second Line : SUITE 2
City : CHICAGO
State : IL
Zip : 60617-3512
Country : US
Telephone Number : 773-375-9300
Fax Number : 773-375-9337
Authorized Official
Title or Position : CEO/PRESIDENT
Name : JOHNNY LEE CARTER JR.
Credential :
Telephone Number : 773-375-9300
Provider Enumeration Date : 03/12/2008
Last Update Date : 03/12/2008

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Directions to “MAHONEY HOME HEALTHCARE SERVICES INC. ” Practice Location

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