Provider Demographics
NPI:1568689073
Name:ACCUCARE HOME NURSING, INC.
Entity Type:Organization
Organization Name:ACCUCARE HOME NURSING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRENDAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:RATIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-353-7360
Mailing Address - Street 1:1999 SPROUL RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-3508
Mailing Address - Country:US
Mailing Address - Phone:610-353-7360
Mailing Address - Fax:610-353-7013
Practice Address - Street 1:1999 SPROUL RD
Practice Address - Street 2:SUITE 1
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-3508
Practice Address - Country:US
Practice Address - Phone:610-353-7360
Practice Address - Fax:610-353-7013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163W00000X, 251J00000X
PA762305251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01528809Medicaid
PA01528809Medicaid