Provider Demographics
NPI:1679023543
Name:HOMECARE OF PENNSYLVANIA
Entity Type:Organization
Organization Name:HOMECARE OF PENNSYLVANIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOENER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-780-8276
Mailing Address - Street 1:239 MAIN ST STE 301
Mailing Address - Street 2:
Mailing Address - City:DICKSON CITY
Mailing Address - State:PA
Mailing Address - Zip Code:18519-1653
Mailing Address - Country:US
Mailing Address - Phone:570-780-8276
Mailing Address - Fax:
Practice Address - Street 1:239 MAIN ST STE 301
Practice Address - Street 2:
Practice Address - City:DICKSON CITY
Practice Address - State:PA
Practice Address - Zip Code:18519-1653
Practice Address - Country:US
Practice Address - Phone:570-780-8276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPA126303OtherHOME IMPROVEMENT CONTRACTOR