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Organization
TRADITIONAL HOME HEALTH AND HOSPICE LLC
Active
Organization
TRADITIONAL HOME HEALTH AND HOSPICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GRAY P BOSSI (ADMINISTRATOR)
(570) 207-9286
Entity
Organization
Contact information
Practice address
113 W DRINKER ST, DUNMORE, PA 18512-1913
(570) 207-9286
Mailing address
113 W DRINKER ST, DUNMORE, PA 18512-1913
(570) 207-9286
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
77740501
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019095000003
—
PA
01
—
817359
BLUE CROSS PROVIDER NUMBE
PA
01
—
83241
GEISINGER PROVIDER NUMBER
PA
Enumeration date
06/01/2005
Last updated
01/08/2020
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