Provider Demographics
NPI:1790241628
Name:HARRISBURG HOME CARE
Entity Type:Organization
Organization Name:HARRISBURG HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:GORING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-291-4383
Mailing Address - Street 1:1713 HAMMEL ROAD
Mailing Address - Street 2:R2
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17011
Mailing Address - Country:US
Mailing Address - Phone:215-291-4383
Mailing Address - Fax:
Practice Address - Street 1:1713 HAMMEL ROAD
Practice Address - Street 2:R2
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17011
Practice Address - Country:US
Practice Address - Phone:215-291-4383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001Medicaid