Provider Demographics
NPI:1558822809
Name:NEW CENTURY HOME CARE LLC
Entity Type:Organization
Organization Name:NEW CENTURY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:REIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-938-5142
Mailing Address - Street 1:2702 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19133-2701
Mailing Address - Country:US
Mailing Address - Phone:267-938-5142
Mailing Address - Fax:267-938-5143
Practice Address - Street 1:2702 N 5TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19133-2701
Practice Address - Country:US
Practice Address - Phone:267-938-5142
Practice Address - Fax:267-938-5143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA123156456Medicaid