Provider Demographics
NPI:1982598900
Name:PAWPAW TREE LLC
Entity type:Organization
Organization Name:PAWPAW TREE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BRANCH MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PETR
Authorized Official - Middle Name:
Authorized Official - Last Name:JELINEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-252-7374
Mailing Address - Street 1:505 S LENOLA RD STE 132
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-1549
Mailing Address - Country:US
Mailing Address - Phone:856-252-7374
Mailing Address - Fax:
Practice Address - Street 1:505 S LENOLA RD STE 132
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-1549
Practice Address - Country:US
Practice Address - Phone:856-252-7374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health