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Organization

ADVANCED NURSING CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHN KUNGU ADMINISTRATOR (ADMINISTRATOR)
(302) 897-4072
Entity
Organization

Contact information

Practice address
63 SURREY WAY, EXTON, PA 19341-1672
(302) 897-4072
Mailing address
63 SURREY WAY, EXTON, PA 19341-1672
(302) 897-4072

Taxonomy

Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
20663601
PA
253Z00000X
In Home Supportive Care Agency
20663601
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20663601
PA DEPT OH HEALTH
PA
Enumeration date
05/11/2011
Last updated
05/11/2011
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