MEDICARE: HARDYS HOMECARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	310400000X	Assisted Living Facility
3	374U00000X	Home Health Aide
4	385H00000X	Respite Care
5	376J00000X	Homemaker

General Provider Information

NPI Number	:	1922772664
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARDYS HOMECARE LLC

Provider Business Mailing Address
First Line	:	6013 CHESTER AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19142-1410
Country	:	US
Telephone Number	:	678-200-7053
Fax Number	:

Provider Business Practice Location Address
First Line	:	6013 CHESTER AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19142-1410
Country	:	US
Telephone Number	:	678-200-7053
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. EDWIN ISAIAH HARDY
Credential	:	OWNER
Telephone Number	:	678-200-7053

Provider Enumeration Date	:	08/05/2021
Last Update Date	:	08/05/2021

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