MEDICARE: S& G TENDER HOME CARE, 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1871143867
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S& G TENDER HOME CARE, LLC

Provider Business Mailing Address
First Line	:	901 W ERIE AVE FL 2
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19140-4321
Country	:	US
Telephone Number	:	215-226-1601
Fax Number	:	215-227-0452

Provider Business Practice Location Address
First Line	:	901 W ERIE AVE FL 2
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19140-4321
Country	:	US
Telephone Number	:	215-226-1601
Fax Number	:	215-227-0452

Authorized Official
Title or Position	:	OWNER
Name	:	MS. GWENDOLYN SCHELL
Credential	:
Telephone Number	:	215-226-1601

Provider Enumeration Date	:	09/12/2019
Last Update Date	:	09/12/2019

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