Provider Demographics
NPI:1083124226
Name:WORTHINGTON HOME CARE AGENCY, LLC
Entity Type:Organization
Organization Name:WORTHINGTON HOME CARE AGENCY, LLC
Other - Org Name:WORTHINGTON HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WORTHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-489-4663
Mailing Address - Street 1:308 ROSECLIFF DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19518-9503
Mailing Address - Country:US
Mailing Address - Phone:610-489-4663
Mailing Address - Fax:
Practice Address - Street 1:409 SECOND AVE STE 302
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-3625
Practice Address - Country:US
Practice Address - Phone:610-489-4663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health