Provider Demographics
NPI:1972999845
Name:AMERICAN SAFETY OPTIONS INC
Entity type:Organization
Organization Name:AMERICAN SAFETY OPTIONS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAMBUO
Authorized Official - Middle Name:
Authorized Official - Last Name:WISNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-812-7025
Mailing Address - Street 1:858 SCHOOL LN
Mailing Address - Street 2:
Mailing Address - City:FOLCROFT
Mailing Address - State:PA
Mailing Address - Zip Code:19032-1724
Mailing Address - Country:US
Mailing Address - Phone:610-812-7025
Mailing Address - Fax:
Practice Address - Street 1:858 SCHOOL LN
Practice Address - Street 2:
Practice Address - City:FOLCROFT
Practice Address - State:PA
Practice Address - Zip Code:19032-1724
Practice Address - Country:US
Practice Address - Phone:610-812-7025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN SAFETY OPTIONS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-08
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA27533601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health