1154724573 NPI number — INFINITY HEALTHCARE SERVICES LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154724573 NPI number — INFINITY HEALTHCARE SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INFINITY HEALTHCARE SERVICES LLC
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:
1154724573
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 W TRENTON AVE
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
MORRISVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19067-2041
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
267-799-4486
Provider Business Mailing Address Fax Number:
267-799-4512

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
610 YORK RD STE 400
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JENKINTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19046-2866
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
267-799-4486
Provider Business Practice Location Address Fax Number:
267-799-4512
Provider Enumeration Date:
09/30/2014

Additional Information

Authorized Official

Authorized Official Last Name:
HUNTER
Authorized Official First Name:
MARK
Authorized Official Middle Name:
ANGEL ANTHONY
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
267-799-4486

Provider Taxonomy Codes

  • Taxonomy code: 251J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QA0600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 322D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QD1600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 385H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QV0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 253J00000X . This is a "MONTANA" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 253Z00000X . This is a "IN HOME SUPPORTIVE CARE" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 34543601 . This is a "PA LICENSE IN-HOME CARE (NON- MEDICAL)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: HP0275200 . This is a "NJ LICENSE HOME HOME CARE LICENCE NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 171WH0202X . This is a "MONTANA" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 6090501 . This is a "PA LICENSE HOME HEALTH (SKILLED )" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 251E00000X . This is a "MONTANA" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 251E00000X . This is a "HOME HEALTH" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 251J00000X . This is a "NURSING CARE" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 13780995 . This is a "CAQH PROVIDER ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 251S00000X . This is a "COMMUNITY/BEHAVIORAL HEALTH/HCBS WAIVER" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 103084867-0001 . This is a "PROMISE ID (PPID)#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 171WH0202X . This is a "CONTRACTOR; HOME MODIFICATIONS" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 251E00000X . This is a "PENNSYLVANIA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 251J00000X . This is a "MONTANA" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 253J00000X . This is a "FOSTER CARE AGENCY" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 310400000X . This is a "ASSISTED LIVING FACILITY" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 0890979 . This is a "NJ MEDICAID ID NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 251S00000X . This is a "MONTANA" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".




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