Organization
SWEET HOME PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JED RYAN (CFO)
(215) 852-0242
Entity
Organization
Contact information
Practice address
426 E ALLEGHENY AVE STE 303, PHILADELPHIA, PA 19134-2338
(215) 739-1400
Mailing address
426 E ALLEGHENY AVE STE 303, PHILADELPHIA, PA 19134-2338
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30796039
PAYER ASSIGNED PROVIDER NUMBER
—
Enumeration date
07/17/2019
Last updated
07/17/2019
About Stedi
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