Organization
PHASE ONE HOME HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALTER M KINARD JR. (MEMBER)
(215) 850-1928
Entity
Organization
Contact information
Practice address
109 CLAYTON CT, NORTH WALES, PA 19454-1828
(215) 850-1928
Mailing address
640 COWPATH RD # 186, LANSDALE, PA 19446-1563
(215) 850-1928
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1036532190001
—
PA
Enumeration date
09/09/2019
Last updated
09/09/2019
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