Provider Demographics
NPI:1497360721
Name:FERTILITY HOME CARE
Entity Type:Organization
Organization Name:FERTILITY HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:267-969-0699
Mailing Address - Street 1:1411 S DARIEN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-5726
Mailing Address - Country:US
Mailing Address - Phone:215-208-8350
Mailing Address - Fax:
Practice Address - Street 1:1411 S DARIEN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-5726
Practice Address - Country:US
Practice Address - Phone:215-208-8350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health