Provider Demographics
NPI:1689432338
Name:PROVIDERS CHOICE HOMECARE
Entity Type:Organization
Organization Name:PROVIDERS CHOICE HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:RENA
Authorized Official - Last Name:MAJOR
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:917-348-3949
Mailing Address - Street 1:1701 VILLAGE GREEN DR
Mailing Address - Street 2:
Mailing Address - City:GILBERTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19525-9595
Mailing Address - Country:US
Mailing Address - Phone:917-348-3949
Mailing Address - Fax:
Practice Address - Street 1:1701 VILLAGE GREEN DR
Practice Address - Street 2:
Practice Address - City:GILBERTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19525-9595
Practice Address - Country:US
Practice Address - Phone:917-348-3949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care