Organization
ADULT GERO PRIME HC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADUNNI MUDIWA WARD NP (OWNER)
(973) 220-5984
Entity
Organization
Contact information
Practice address
240 N WYCOMBE AVE, LANSDOWNE, PA 19050-1618
(973) 220-5984
(215) 664-5565
Mailing address
240 N WYCOMBE AVE, LANSDOWNE, PA 19050-1618
(973) 220-5984
(215) 664-5565
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477217180
—
PA
Enumeration date
05/24/2024
Last updated
05/24/2024
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