Provider Demographics
NPI:1043468077
Name:COMMUNITYCARE HOSPICE SERVICES OF PENNSYLVANIA, LLC
Entity Type:Organization
Organization Name:COMMUNITYCARE HOSPICE SERVICES OF PENNSYLVANIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERDINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:215-690-4058
Mailing Address - Street 1:210 YORKTOWN PLZ
Mailing Address - Street 2:STE. 210
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-1424
Mailing Address - Country:US
Mailing Address - Phone:215-690-4058
Mailing Address - Fax:215-884-3766
Practice Address - Street 1:210 YORKTOWN PLZ
Practice Address - Street 2:STE. 210
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-1424
Practice Address - Country:US
Practice Address - Phone:215-690-4058
Practice Address - Fax:215-884-3766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based