Provider Demographics
NPI:1427241785
Name:HOSPITAL DRIVE HOMECARE, INC
Entity type:Organization
Organization Name:HOSPITAL DRIVE HOMECARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:PARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-963-0744
Mailing Address - Street 1:9 BECKETT CLOSE
Mailing Address - Street 2:
Mailing Address - City:MOOSIC
Mailing Address - State:PA
Mailing Address - Zip Code:18507-1929
Mailing Address - Country:US
Mailing Address - Phone:570-348-9442
Mailing Address - Fax:
Practice Address - Street 1:4113 BIRNEY AVE
Practice Address - Street 2:
Practice Address - City:MOOSIC
Practice Address - State:PA
Practice Address - Zip Code:18507-1301
Practice Address - Country:US
Practice Address - Phone:570-348-9442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3000008176332B00000X, 332BP3500X, 332BX2000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3000008176OtherPA DEPT OF HEALTH
PA3000008176OtherPA DEPT OF HEALTH