1306241195 NPI number — PHILIA HOME CARE

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 1306241195 NPI number — PHILIA HOME CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PHILIA HOME CARE
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:
1306241195
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/23/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4420 CONNECTICUT AVE NW SUITE 202
Provider Second Line Business Mailing Address:
PHILIA HOME CARE
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20008-8050
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-607-2525
Provider Business Mailing Address Fax Number:
202-607-2527

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4420 CONNECTICUT AVE NW SUITE 202
Provider Second Line Business Practice Location Address:
PHILIA HOME CARE
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20008-8050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-607-2525
Provider Business Practice Location Address Fax Number:
202-607-2527
Provider Enumeration Date:
10/23/2014

Additional Information

Authorized Official

Authorized Official Last Name:
TEWALT
Authorized Official First Name:
KIRA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT PHILIA HOMECARE
Authorized Official Telephone Number:
202-607-2525

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  NR130103 NURSING REF , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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