Organization
SUCCESSFUL AGING CARE NET INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. INNOCENT ONWUBIKO MSHA, MSGS (OWNER)
(484) 461-8711
Entity
Organization
Contact information
Practice address
48 GARRETT RD, UPPER DARBY, PA 19082-2303
(484) 461-8711
(610) 284-4170
Mailing address
48 GARRETT RD, UPPER DARBY, PA 19082-2303
(484) 461-8711
(610) 284-4170
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
80200501
PA
332B00000X
Durable Medical Equipment & Medical Supplies
5418770001
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011366320001
—
PA
05
—
1011366320002
—
PA
01
—
80200501
HOME HEALTHCARE LICENSE
PA
Enumeration date
11/16/2005
Last updated
05/26/2011
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