Provider Demographics
NPI:1386712677
Name:MAHOGANY HEALTH CARE
Entity type:Organization
Organization Name:MAHOGANY HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DWAYNE
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ROYSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-237-4503
Mailing Address - Street 1:270 GEIGER RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-1016
Mailing Address - Country:US
Mailing Address - Phone:215-237-4503
Mailing Address - Fax:215-464-7308
Practice Address - Street 1:270 GEIGER RD
Practice Address - Street 2:SUITE F
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-1016
Practice Address - Country:US
Practice Address - Phone:215-237-4503
Practice Address - Fax:215-464-7308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based