MEDICARE: MS. PHYLLIS MWAURA

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	172V00000X	Community Health Worker	42963601	PA
2	251E00000X	Home Health Agency	42963601	PA
3	251T00000X	PACE Provider Organization	42963601	PA
4	332B00000X	Durable Medical Equipment & Medical Supplies	42963601	PA
5	343900000X	Non-emergency Medical Transport (VAN)	42963601	PA
6	347C00000X	Private Vehicle	42963601	PA
7	372500000X	Chore Provider	42963601	PA
8	385H00000X	Respite Care	42963601	PA
9	372600000X	Adult Companion	42963601	PA
10	376J00000X	Homemaker	42963601	PA
11	376K00000X	Nurse's Aide	42963601	PA
12	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1982058681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PHYLLIS MWAURA

Provider Business Mailing Address
First Line	:	309 SANFORD RD
Second Line	:
City	:	UPPER DARBY
State	:	PA
Zip	:	19082-4716
Country	:	US
Telephone Number	:	302-444-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	309 SANFORD RD
Second Line	:
City	:	UPPER DARBY
State	:	PA
Zip	:	19082-4716
Country	:	US
Telephone Number	:	302-444-7000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2016
Last Update Date	:	01/22/2024

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Directions to “ MS. PHYLLIS MWAURA ” Practice Location

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