Provider Demographics
NPI:1114911229
Name:P-B HEALTH HOME CARE AGENCY, INC.
Entity Type:Organization
Organization Name:P-B HEALTH HOME CARE AGENCY, INC.
Other - Org Name:P-B HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE PROJECT MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LENA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-235-1060
Mailing Address - Street 1:4701 MOUNT HOPE DR STE B
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-3246
Mailing Address - Country:US
Mailing Address - Phone:410-235-1060
Mailing Address - Fax:410-235-1309
Practice Address - Street 1:4701 MOUNT HOPE DR STE B
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-3213
Practice Address - Country:US
Practice Address - Phone:410-235-1060
Practice Address - Fax:410-235-1309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-02
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDHH7134251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD289283900Medicaid
MD217134Medicare Oscar/Certification