MEDICARE: WANNACARE, 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
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1942828918
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WANNACARE, LLC.

Provider Business Mailing Address
First Line	:	1900 MARKET ST FL 8
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-3527
Country	:	US
Telephone Number	:	215-397-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 MARKET ST FL 8
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-3527
Country	:	US
Telephone Number	:	215-397-7000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GERSHON STRASSER
Credential	:
Telephone Number	:	215-397-7000

Provider Enumeration Date	:	07/07/2020
Last Update Date	:	07/07/2020

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