Provider Demographics
NPI:1144228677
Name:MCNELIS HOME CARE COMPANY INC.
Entity Type:Organization
Organization Name:MCNELIS HOME CARE COMPANY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:MCNELIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-459-0202
Mailing Address - Street 1:785 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-7684
Mailing Address - Country:US
Mailing Address - Phone:570-459-0202
Mailing Address - Fax:570-459-0607
Practice Address - Street 1:785 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-7684
Practice Address - Country:US
Practice Address - Phone:570-459-0202
Practice Address - Fax:570-459-0607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010876700001Medicaid
PA0261600001Medicare ID - Type Unspecified