Provider Demographics
NPI:1013539337
Name:DEVINECARE HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:DEVINECARE HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MODUPE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLOWODAHUNSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-474-9931
Mailing Address - Street 1:1751 S VALLEY FORGE RD
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-5418
Mailing Address - Country:US
Mailing Address - Phone:267-474-9931
Mailing Address - Fax:
Practice Address - Street 1:1751 S VALLEY FORGE RD
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-5418
Practice Address - Country:US
Practice Address - Phone:267-474-9931
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7050818OtherSOS ENTITY NUMBER