Provider Demographics
NPI:1588660377
Name:ERWINES HOME HEALTH AND HOSPICE, INC
Entity Type:Organization
Organization Name:ERWINES HOME HEALTH AND HOSPICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ERWINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-288-1013
Mailing Address - Street 1:270 PIERCE ST
Mailing Address - Street 2:STE 101
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-5141
Mailing Address - Country:US
Mailing Address - Phone:570-288-1013
Mailing Address - Fax:570-288-6569
Practice Address - Street 1:270 PIERCE ST
Practice Address - Street 2:STE 208
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-5141
Practice Address - Country:US
Practice Address - Phone:570-288-1013
Practice Address - Fax:570-283-3722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-26
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA398010251E00000X
PA391675251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011199360001Medicaid
PA398010Medicare ID - Type UnspecifiedHOME HEALTH AND HOSPICE
PA1011199360001Medicaid