Provider Demographics
NPI:1568072270
Name:PROLIFIC HOMECARE LLC
Entity Type:Organization
Organization Name:PROLIFIC HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MD
Authorized Official - Prefix:MS
Authorized Official - First Name:KIKELOMO
Authorized Official - Middle Name:A
Authorized Official - Last Name:OYINLOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN
Authorized Official - Phone:908-906-2828
Mailing Address - Street 1:5 NESHAMINY INTERPLEX DR STE 205
Mailing Address - Street 2:
Mailing Address - City:TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6932
Mailing Address - Country:US
Mailing Address - Phone:215-245-2285
Mailing Address - Fax:
Practice Address - Street 1:5 NESHAMINY INTERPLEX DR STE 205
Practice Address - Street 2:
Practice Address - City:TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6932
Practice Address - Country:US
Practice Address - Phone:215-245-2285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-06
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care