Provider Demographics
NPI:1104138726
Name:T.L. ZURILLA, INC
Entity type:Organization
Organization Name:T.L. ZURILLA, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZURILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-693-2911
Mailing Address - Street 1:1923 PLANK RD
Mailing Address - Street 2:
Mailing Address - City:DUNCANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16635-8385
Mailing Address - Country:US
Mailing Address - Phone:814-693-2911
Mailing Address - Fax:814-693-2912
Practice Address - Street 1:1923 PLANK RD
Practice Address - Street 2:
Practice Address - City:DUNCANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16635-8385
Practice Address - Country:US
Practice Address - Phone:814-693-2911
Practice Address - Fax:814-693-2912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-12
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA10263601251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1104138726OtherNPI
PA10263601OtherPENNSYLVANIA DEPARTMENT OF HEALTH, HOME CARE CERTIFICATE OF LICENSURE
PA1024747050001Medicaid