Provider Demographics
NPI:1568448611
Name:TOWER HEALTH AT HOME
Entity Type:Organization
Organization Name:TOWER HEALTH AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUCILLE
Authorized Official - Middle Name:D
Authorized Official - Last Name:GOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN, MBA
Authorized Official - Phone:610-378-0481
Mailing Address - Street 1:1170 BERKSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1215
Mailing Address - Country:US
Mailing Address - Phone:610-378-0481
Mailing Address - Fax:610-378-9762
Practice Address - Street 1:1170 BERKSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1215
Practice Address - Country:US
Practice Address - Phone:610-378-0481
Practice Address - Fax:610-378-9762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA780790Medicare ID - Type UnspecifiedMEDICARE PART B
600001385Medicare ID - Type UnspecifiedRR MEDICARE