Provider Demographics
NPI:1588125108
Name:AMD SENIOR PURECARE LLC
Entity type:Organization
Organization Name:AMD SENIOR PURECARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RUTUL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-714-7444
Mailing Address - Street 1:1013 W COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-1002
Mailing Address - Country:US
Mailing Address - Phone:215-714-7444
Mailing Address - Fax:888-285-5812
Practice Address - Street 1:1013 W COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:HATBORO
Practice Address - State:PA
Practice Address - Zip Code:19040-1002
Practice Address - Country:US
Practice Address - Phone:215-714-7444
Practice Address - Fax:888-285-5812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-27
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care