Organization
PENNSTATE HOME CARE SERVICES
Active
Other names
PennState Home Care Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HUSSEIN A AHMED (PRESIDENT)
(267) 297-7265
Entity
Organization
Contact information
Practice address
5223 GERMANTOWN AVE STE 103, PHILADELPHIA, PA 19144-2301
(267) 399-0314
Mailing address
5223 GERMANTOWN AVE STE 103, PHILADELPHIA, PA 19144-2301
(267) 399-0314
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103374123-0001
WAIVER PROVIDER
PA
Enumeration date
01/24/2018
Last updated
01/24/2018
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