Provider Demographics
NPI:1750830386
Name:SWEET HOME PRIMARY CARE OF SCRANTON
Entity Type:Organization
Organization Name:SWEET HOME PRIMARY CARE OF SCRANTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TEKIA
Authorized Official - Middle Name:
Authorized Official - Last Name:EMERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-919-8900
Mailing Address - Street 1:329 PENN AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503-1248
Mailing Address - Country:US
Mailing Address - Phone:570-880-7271
Mailing Address - Fax:
Practice Address - Street 1:329 PENN AVE STE 202
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1248
Practice Address - Country:US
Practice Address - Phone:570-880-7271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA29063601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care