Organization
BERWICK HOME CARE SERVICES LLC
Active
Other names
Commonwealth Home Health & Hospice of Berwick
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA L. PROFFITT (TREASURER)
(337) 233-1307
Entity
Organization
Contact information
Practice address
1409 N MARKET ST STE 201, BERWICK, PA 18603-2140
(570) 520-4063
(570) 520-4214
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
727205
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
075759
FIRST PRIORITY BCBS HMO
—
05
—
1024488590002
—
PA
01
—
1526683
GATEWAY MANAGED CARE MA
—
01
—
30843
GHP GOLD & COMMERCIAL
—
Enumeration date
07/10/2006
Last updated
07/29/2020
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