Provider Demographics
NPI:1346788270
Name:MCMANUS HOME HEALTHCARE AGENCY INC
Entity Type:Organization
Organization Name:MCMANUS HOME HEALTHCARE AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCMANUS
Authorized Official - Suffix:JR
Authorized Official - Credentials:RN
Authorized Official - Phone:215-432-8384
Mailing Address - Street 1:2336 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-4417
Mailing Address - Country:US
Mailing Address - Phone:215-821-8408
Mailing Address - Fax:215-334-0300
Practice Address - Street 1:2336 S BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-4417
Practice Address - Country:US
Practice Address - Phone:215-821-8408
Practice Address - Fax:610-601-1535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-12
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA06710501OtherSTATE LICENSE
PA103736222-0001Medicaid