Provider Demographics
NPI:1467434761
Name:MOSES TAYLOR HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:MOSES TAYLOR HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ROE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-340-2991
Mailing Address - Street 1:700 QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1724
Mailing Address - Country:US
Mailing Address - Phone:570-340-2700
Mailing Address - Fax:570-340-2799
Practice Address - Street 1:700 QUINCY AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1724
Practice Address - Country:US
Practice Address - Phone:570-340-2700
Practice Address - Fax:570-340-2799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA761105251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA20007793OtherAMERIHEALTH MERCY
PA397611OtherBLUE CROSS INSURANCE
PA810114OtherFIRST PRIORITY HEALTH
PA2Y5765OtherHEALTH NET INSURANCE
PA000000025175OtherMED PLUS THREE RIVERS
PA75877800OtherFEDERAL BLACK LUNG
PA1007771410018Medicaid
PA2329840OtherAETNA INSURANCE
PA43016OtherGEISINGER HEALTH PLAN
PA810114OtherFIRST PRIORITY HEALTH