Provider Demographics
NPI:1275594699
Name:PHILLIP PAUL WEINER
Entity Type:Organization
Organization Name:PHILLIP PAUL WEINER
Other - Org Name:WEINERS HOME HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWINER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:WEINER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:410-653-1433
Mailing Address - Street 1:3635 OLD COURT RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3915
Mailing Address - Country:US
Mailing Address - Phone:410-653-1433
Mailing Address - Fax:410-653-0319
Practice Address - Street 1:3635 OLD COURT RD
Practice Address - Street 2:SUITE C
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-3915
Practice Address - Country:US
Practice Address - Phone:410-653-1433
Practice Address - Fax:410-653-0319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0386940001Medicare NSC