Provider Demographics
NPI:1194964981
Name:PHILADELPHIA HOME CARE AGENCY, INC
Entity type:Organization
Organization Name:PHILADELPHIA HOME CARE AGENCY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:IZOLDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-947-8555
Mailing Address - Street 1:78 TRACEY RD
Mailing Address - Street 2:UNIT A
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-4222
Mailing Address - Country:US
Mailing Address - Phone:215-947-8555
Mailing Address - Fax:215-947-8557
Practice Address - Street 1:78 TRACEY RD
Practice Address - Street 2:UNIT A
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-4222
Practice Address - Country:US
Practice Address - Phone:215-947-8555
Practice Address - Fax:215-947-8557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA398103Medicare Oscar/Certification