Provider Demographics
NPI:1619498813
Name:FOX CHASE HOME CARE, INC.
Entity Type:Organization
Organization Name:FOX CHASE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:GALIBOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-969-2425
Mailing Address - Street 1:7770 DUGAN ROAD UNIT 1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111
Mailing Address - Country:US
Mailing Address - Phone:267-538-4650
Mailing Address - Fax:267-538-4621
Practice Address - Street 1:7770 DUNGAN RD STE 1
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-2700
Practice Address - Country:US
Practice Address - Phone:267-538-4650
Practice Address - Fax:267-538-4621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2278H0200X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA33153601OtherHOME CARE LICENSE