Provider Demographics
NPI:1497399646
Name:MARY HEALTHCARE SERVICES, LLC.
Entity Type:Organization
Organization Name:MARY HEALTHCARE SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAM
Authorized Official - Middle Name:
Authorized Official - Last Name:TIRATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-598-3158
Mailing Address - Street 1:21 S CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-2816
Mailing Address - Country:US
Mailing Address - Phone:484-598-3158
Mailing Address - Fax:
Practice Address - Street 1:21 S CEDAR LN
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-2816
Practice Address - Country:US
Practice Address - Phone:484-598-3158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-31
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health