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NPI Code Detail

MEDICARE: ELDERLY CARE GROUP LLC

MEDICARE: ELDERLY CARE GROUP 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
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1932333481
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELDERLY CARE GROUP LLC
Provider Business Mailing Address
First Line : 11892 FERNDALE ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19116-2008
Country : US
Telephone Number : 917-991-4869
Fax Number :
Provider Business Practice Location Address
First Line : 11892 FERNDALE ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19116-2008
Country : US
Telephone Number : 917-991-4869
Fax Number :
Authorized Official
Title or Position : MEMBER
Name : MICHAEL VOLLER
Credential :
Telephone Number : 917-991-4869
Provider Enumeration Date : 05/13/2009
Last Update Date : 05/13/2009

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Directions to “ELDERLY CARE GROUP LLC ” Practice Location

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