Organization
PROFESSIONAL HOME CARE SERVICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER CHARLES STIELAU JR. PHARMD (DIRECTOR)
(610) 323-8750
Entity
Organization
Contact information
Practice address
911 NORTH CHARLOTTE STREET, POTTSTOWN, PA 19464
(610) 323-8750
(610) 326-0850
Mailing address
911 NORTH CHARLOTTE STREET, POTTSTOWN, PA 19464
(610) 323-8750
(610) 326-0850
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
PP414200L
PA
333600000X
Pharmacy
PP414200L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001183273-002
—
PA
01
—
0431020001
MEDICARE
PA
Enumeration date
11/15/2005
Last updated
03/16/2015
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