Provider Demographics
NPI:1992763908
Name:CHADDS FORD ALTERNACARE, INC.
Entity type:Organization
Organization Name:CHADDS FORD ALTERNACARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:PANACCIO
Authorized Official - Suffix:
Authorized Official - Credentials:MSS
Authorized Official - Phone:610-675-1111
Mailing Address - Street 1:5 CHRISTY DRIVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-9682
Mailing Address - Country:US
Mailing Address - Phone:610-675-1111
Mailing Address - Fax:610-675-1112
Practice Address - Street 1:5 CHRISTY DRIVE
Practice Address - Street 2:SUITE 104
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-9682
Practice Address - Country:US
Practice Address - Phone:610-675-1111
Practice Address - Fax:610-675-1112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA765305251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1557490Medicaid
PA397653Medicare Oscar/Certification