1821455353 NPI number — PATIENT BLISS HOME CARE AGENCY, INC.

Table of content: (NPI 1821455353)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821455353 NPI number — PATIENT BLISS HOME CARE AGENCY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PATIENT BLISS HOME CARE AGENCY, 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:
6
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:
1821455353
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ONE NESHAMINI INTERPLEX
Provider Second Line Business Mailing Address:
SUITE 106
Provider Business Mailing Address City Name:
FEASTERVILLE TREVOSE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19053-6969
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-780-5475
Provider Business Mailing Address Fax Number:
215-359-1691

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ONE NESHAMINI INTERPLEX
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
FEASTERVILLE TREVOSE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19053-6969
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-780-5475
Provider Business Practice Location Address Fax Number:
215-359-1691
Provider Enumeration Date:
01/28/2016

Additional Information

Authorized Official

Authorized Official Last Name:
CHERKASSKY
Authorized Official First Name:
YULINA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER / CEO
Authorized Official Telephone Number:
215-780-5475

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  06250501 , 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: 103237993-0002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com