Provider Demographics
NPI:1558655639
Name:HOUSECALL MEDICAL GROUP INC
Entity Type:Organization
Organization Name:HOUSECALL MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MYRON
Authorized Official - Middle Name:
Authorized Official - Last Name:RODOS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-322-8888
Mailing Address - Street 1:450 JEANES ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-3241
Mailing Address - Country:US
Mailing Address - Phone:215-322-8888
Mailing Address - Fax:267-775-3345
Practice Address - Street 1:450 JEANES ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-3241
Practice Address - Country:US
Practice Address - Phone:215-322-8888
Practice Address - Fax:267-775-3345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-06
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health