1487675666 NPI number — CAS HOME HEALTH CARE, INC.

Table of content: (NPI 1487675666)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487675666 NPI number — CAS HOME HEALTH CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAS HOME HEALTH CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487675666
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/02/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9200 MARSHALL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19114
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-831-8008
Provider Business Mailing Address Fax Number:
215-831-1011

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9200 MARSHALL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-831-8008
Provider Business Practice Location Address Fax Number:
215-831-1011
Provider Enumeration Date:
07/22/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BARNETTE
Authorized Official First Name:
BETTY
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
215-831-8008

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  02330501 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 101150471-0001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 101150471-0002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02330501 . This is a "PA DEPARTMENT OF HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".