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Organization
EXTRACARE HOMECARE SERVICES
Active
Organization
EXTRACARE HOMECARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSINAKACHI EGBUKWU (ADMINISTRATOR)
(267) 455-9577
Entity
Organization
Contact information
Practice address
670 CHURCH LN, 2ND FLOOR FRONT, YEADON, PA 19050-3301
(267) 455-9577
(484) 540-7913
Mailing address
670 CHURCH LN, 2ND FLOOR FRONT, YEADON, PA 19050-3301
(267) 455-9577
(484) 540-7913
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42373601
PROVIDER LICENSE NUMBER
PA
Enumeration date
10/08/2019
Last updated
10/08/2019
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