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Organization
JEWISH HOME OF EASTERN PENNSYLVANIA
Active
Organization
JEWISH HOME OF EASTERN PENNSYLVANIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL K SANDHAUS (EXECUTIVE DIRECTOR)
(570) 344-6177
Entity
Organization
Contact information
Practice address
1101 VINE ST, SCRANTON, PA 18510-2126
(570) 344-6177
(570) 344-9610
Mailing address
1101 VINE ST, SCRANTON, PA 18510-2126
(570) 344-6177
(570) 344-9610
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
360402
PA
332BN1400X
Nursing Facility Supplies (DME)
360402
PA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
360402
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007472840001
—
PA
Enumeration date
07/12/2005
Last updated
04/22/2008
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