Provider Demographics
NPI:1285353995
Name:PERFECT MATCH HEALTH AND WELLNESS
Entity type:Organization
Organization Name:PERFECT MATCH HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:DARNETTE
Authorized Official - Last Name:BREW
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:267-206-9655
Mailing Address - Street 1:4833 PULASKI AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-4128
Mailing Address - Country:US
Mailing Address - Phone:267-206-9655
Mailing Address - Fax:
Practice Address - Street 1:4833 PULASKI AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-4128
Practice Address - Country:US
Practice Address - Phone:267-206-9655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-25
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care