Provider Demographics
NPI:1659707255
Name:SYNERGY CARE SERVICES
Entity Type:Organization
Organization Name:SYNERGY CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADEMOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OWODUNNI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-570-9661
Mailing Address - Street 1:5934 TORRESDALE AVE
Mailing Address - Street 2:PO BOX 17700
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19135-4151
Mailing Address - Country:US
Mailing Address - Phone:215-570-9661
Mailing Address - Fax:215-885-5014
Practice Address - Street 1:5934 TORRESDALE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19135-4151
Practice Address - Country:US
Practice Address - Phone:215-570-9661
Practice Address - Fax:215-885-5014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH000481251E00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1306987706OtherNPI