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Organization

ESSENT HEALTHCARE - WAYNESBURG LLC

Active
Other names
Southwestern Home Care
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHEN L. PAGE (VICE PRESIDENT)
(615) 844-9849
Entity
Organization

Contact information

Practice address
265 ELM DRIVE, SUITE 2, WAYNESBURG, PA 15370
(724) 627-1900
(724) 627-1998
Mailing address
265 ELM DRIVE, SUITE 2, WAYNESBURG, PA 15370
(724) 627-1900
(724) 627-1998

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
713805
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0756
BLUE CROSS
PA
01
0812609
UMWA
PA
05
1007722070007
PA
01
1500357
GATEWAY
PA
01
395772
FEDERAL BLACK LUNG
PA
01
53513
ADVANTRA/HEALTH ASSURANCE
PA
01
75735
THREE RIVERS/MED PLUS
PA
Enumeration date
10/12/2005
Last updated
02/11/2014
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