Organization
DYNAMIC HOME HEALTH CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ILYA IVANOV RN, EMT (ADMINISTRATOR)
(215) 870-3441
Entity
Organization
Contact information
Practice address
550 STATE RD, SUITE 104, BENSALEM, PA 19020-8702
(215) 244-4466
Mailing address
550 STATE RD, SUITE 104, BENSALEM, PA 19020-8702
(215) 244-4466
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
03750501
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102455620 0001
—
PA
Enumeration date
09/14/2009
Last updated
06/25/2010
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