Provider Demographics
NPI:1689827909
Name:DICKS HOME CARE INC
Entity Type:Organization
Organization Name:DICKS HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-949-6764
Mailing Address - Street 1:440 GATEWAY AVE
Mailing Address - Street 2:GATEWAY CENTER
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-7351
Mailing Address - Country:US
Mailing Address - Phone:717-264-1799
Mailing Address - Fax:717-264-1899
Practice Address - Street 1:440 GATEWAY AVE
Practice Address - Street 2:GATEWAY CENTER
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-7351
Practice Address - Country:US
Practice Address - Phone:717-264-1799
Practice Address - Fax:717-264-1899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3000008026332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA232694OtherHIGHMARK
PA39HA34OtherCAPITAL BLUE CROSS
PA1007550730015Medicaid
PA1007550730015Medicaid