Provider Demographics
NPI:1558368589
Name:BROTHERSTON HOMECARE, INC.
Entity Type:Organization
Organization Name:BROTHERSTON HOMECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:FEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-633-7300
Mailing Address - Street 1:1412 WELLS DR
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-4468
Mailing Address - Country:US
Mailing Address - Phone:215-633-7300
Mailing Address - Fax:215-633-7304
Practice Address - Street 1:1412 WELLS DR
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-4468
Practice Address - Country:US
Practice Address - Phone:215-633-7300
Practice Address - Fax:215-633-7304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-06
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000003436332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012078200002Medicaid
PA0012078200002Medicaid