Provider Demographics
NPI:1245743772
Name:AAA MAINLINE HOME HEALTH CARE
Entity Type:Organization
Organization Name:AAA MAINLINE HOME HEALTH CARE
Other - Org Name:AAA MAINLINE HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/C.E.O
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-340-8359
Mailing Address - Street 1:3021 DOWITCHER PL
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19142-3308
Mailing Address - Country:US
Mailing Address - Phone:267-340-8359
Mailing Address - Fax:
Practice Address - Street 1:3021 DOWITCHER PL
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-3308
Practice Address - Country:US
Practice Address - Phone:267-340-8359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA836-2908523251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health