1043895873 NPI number — IN LOVING HANDS HOME HEALTH CARE SERVICE

Table of content: (NPI 1043895873)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043895873 NPI number — IN LOVING HANDS HOME HEALTH CARE SERVICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
IN LOVING HANDS HOME HEALTH CARE SERVICE
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:
1043895873
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
325 MILL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRISTOL
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19007-4833
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-458-7656
Provider Business Mailing Address Fax Number:
215-458-8143

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
325 MILL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRISTOL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19007-4833
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-458-7656
Provider Business Practice Location Address Fax Number:
215-458-8143
Provider Enumeration Date:
03/12/2021

Additional Information

Authorized Official

Authorized Official Last Name:
LAIDLER
Authorized Official First Name:
TYNESHIA
Authorized Official Middle Name:
S
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
215-458-7656

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 103987634-001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com