Provider Demographics
NPI:1437702966
Name:PENNWOODS HOME HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:PENNWOODS HOME HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WALI
Authorized Official - Middle Name:ABDUL
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-596-6607
Mailing Address - Street 1:7701 LINDBERGH BLVD APT 1702
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19153-2120
Mailing Address - Country:US
Mailing Address - Phone:267-596-6607
Mailing Address - Fax:215-397-4939
Practice Address - Street 1:7701 LINDBERGH BLVD APT 1702
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19153-2120
Practice Address - Country:US
Practice Address - Phone:267-713-7032
Practice Address - Fax:215-397-4939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health