Organization
HERITAGE MEDICAL STAFFING,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OTTO EYOMA MR (MEMBER PARTNER)
(717) 350-8778
Entity
Organization
Contact information
Practice address
320 EMERALD ST, HARRISBURG, PA 17110-1820
(717) 901-4045
(717) 901-4046
Mailing address
320 EMERALD ST, HARRISBURG, PA 17110-1820
(717) 370-7090
(717) 370-7090
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
10793601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10793601
HOME CARE LICENSE
PA
Enumeration date
02/08/2010
Last updated
02/11/2014
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