Provider Demographics
NPI:1346139375
Name:ICONHEARTS CARE SERVICES LLC
Entity type:Organization
Organization Name:ICONHEARTS CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FUAD
Authorized Official - Middle Name:
Authorized Official - Last Name:OLOWO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-651-3062
Mailing Address - Street 1:41 UNIVERSITY DR STE 400
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1873
Mailing Address - Country:US
Mailing Address - Phone:607-651-3062
Mailing Address - Fax:
Practice Address - Street 1:41 UNIVERSITY DR
Practice Address - Street 2:SUITE 400
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940
Practice Address - Country:US
Practice Address - Phone:607-651-3062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care