Provider Demographics
NPI:1245237676
Name:RENAISSANCE HOME CARE INC
Entity Type:Organization
Organization Name:RENAISSANCE HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:MURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-563-5055
Mailing Address - Street 1:7900 STEUBENVILLE PIKE STE 31
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:PA
Mailing Address - Zip Code:15126-9143
Mailing Address - Country:US
Mailing Address - Phone:412-563-5055
Mailing Address - Fax:412-563-4434
Practice Address - Street 1:1145 BOWER HILL RD
Practice Address - Street 2:STE 201
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1342
Practice Address - Country:US
Practice Address - Phone:412-563-5055
Practice Address - Fax:412-563-4434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA762405251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01553220004Medicaid
PA1050OtherBC/BS
PA397624Medicare ID - Type Unspecified