Provider Demographics
NPI:1033434402
Name:ABC PEDIATRIC HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:ABC PEDIATRIC HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMELSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-773-9250
Mailing Address - Street 1:65 W. STREET RD
Mailing Address - Street 2:SUITE A204
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-3229
Mailing Address - Country:US
Mailing Address - Phone:215-274-5777
Mailing Address - Fax:215-274-5647
Practice Address - Street 1:65 W. STREET RD
Practice Address - Street 2:SUITE A204
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-3229
Practice Address - Country:US
Practice Address - Phone:215-274-5777
Practice Address - Fax:215-274-5647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-29
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA04060501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health