Provider Demographics
NPI:1972813301
Name:FAMILY HOME MEDICAL HOSPICE, INC.
Entity type:Organization
Organization Name:FAMILY HOME MEDICAL HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:PETRAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-632-1406
Mailing Address - Street 1:121 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT CARMEL
Mailing Address - State:PA
Mailing Address - Zip Code:17851-2140
Mailing Address - Country:US
Mailing Address - Phone:570-339-4049
Mailing Address - Fax:570-339-1643
Practice Address - Street 1:121 E 5TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT CARMEL
Practice Address - State:PA
Practice Address - Zip Code:17851-2140
Practice Address - Country:US
Practice Address - Phone:570-339-4049
Practice Address - Fax:570-339-1643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-19
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based