Provider Demographics
NPI:1811201395
Name:JERRILYN HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:JERRILYN HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:KORLUBAH
Authorized Official - Last Name:YOGBOH
Authorized Official - Suffix:SR
Authorized Official - Credentials:MS
Authorized Official - Phone:267-254-4551
Mailing Address - Street 1:6628 WOODLAND AVE
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19142-2223
Mailing Address - Country:US
Mailing Address - Phone:267-254-4551
Mailing Address - Fax:215-379-1239
Practice Address - Street 1:6628 WOODLAND AVENUE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142
Practice Address - Country:US
Practice Address - Phone:267-254-4551
Practice Address - Fax:215-739-1239
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TECHONE SOLUTIONS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health