Provider Demographics
NPI:1457661118
Name:A&E HOME CARE LLC
Entity Type:Organization
Organization Name:A&E HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSHER
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:570-401-2681
Mailing Address - Street 1:740 WALLACE WAY
Mailing Address - Street 2:
Mailing Address - City:WEATHERLY
Mailing Address - State:PA
Mailing Address - Zip Code:18255-3360
Mailing Address - Country:US
Mailing Address - Phone:570-401-2681
Mailing Address - Fax:570-427-9892
Practice Address - Street 1:740 WALLACE WAY
Practice Address - Street 2:
Practice Address - City:WEATHERLY
Practice Address - State:PA
Practice Address - Zip Code:18255-3360
Practice Address - Country:US
Practice Address - Phone:570-401-2681
Practice Address - Fax:570-427-9892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-15
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA04200501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health