Provider Demographics
NPI:1164986295
Name:EDOMIGHT CARE SERVICES LLC
Entity Type:Organization
Organization Name:EDOMIGHT CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINUS
Authorized Official - Middle Name:
Authorized Official - Last Name:EDOMOBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-971-2456
Mailing Address - Street 1:6148 WHEELER ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19142-3214
Mailing Address - Country:US
Mailing Address - Phone:267-971-2456
Mailing Address - Fax:
Practice Address - Street 1:6148 WHEELER ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-3214
Practice Address - Country:US
Practice Address - Phone:267-971-2456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health