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Organization

PREMIER HEALTH PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAULINE WANDETO (CEO)
(610) 690-9605
Entity
Organization

Contact information

Practice address
202 W ALBEMARLE AVE, LANSDOWNE, PA 19050-1127
(610) 690-9605
Mailing address
202 W ALBEMARLE AVE, LANSDOWNE, PA 19050-1127
(610) 690-9605

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
251B00000X
Case Management Agency
251E00000X
Home Health Agency
251G00000X
Community Based Hospice Care Agency
251S00000X
Community/Behavioral Health Agency
253Z00000X
In Home Supportive Care Agency
311ZA0620X
Adult Care Home Facility
315P00000X
Intellectual Disabilities Intermediate Care Facility
332BC3200X
Customized Equipment (DME)
343900000X
Non-emergency Medical Transport (VAN)
347C00000X
Private Vehicle
385H00000X
Respite Care

Other

Enumeration date
01/22/2024
Last updated
01/22/2024
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