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Organization

PRIMARY HOMECARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISA GILL DNP, CRNP (CCO)
(215) 635-3151
Entity
Organization

Contact information

Practice address
8118 OLD YORK RD, SUITE D, ELKINS PARK, PA 19027-1423
(215) 635-3151
(215) 635-3165
Mailing address
8118 OLD YORK RD, SUITE D, ELKINS PARK, PA 19027-1423
(215) 635-3151
(215) 635-3165

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
363LP2300X
Primary Care Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0018226880010
PA
05
101916277 0001
PA
Enumeration date
05/22/2006
Last updated
02/15/2023
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