Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
PROMINENCE HOME HEALTH CARE AGENCY, LLC
Active
Organization
PROMINENCE HOME HEALTH CARE AGENCY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FREDDIE L. FAGAN JR. (CHIEF EXECUTIVE OFFICER)
(850) 691-7860
Entity
Organization
Contact information
Practice address
1800 MARKET ST, HARRISBURG, PA 17103-2523
(850) 691-7860
Mailing address
1800 MARKET ST, HARRISBURG, PA 17103-2523
(850) 691-7860
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48703601
PENNSYLVANIA DEPARTMENT OF HEALTH CERTIFICATE OF LICENSURE
PA
Enumeration date
06/14/2019
Last updated
06/24/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up