Provider Demographics
NPI:1831100700
Name:DICK'S HOMECARE, INC
Entity Type:Organization
Organization Name:DICK'S HOMECARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-949-6764
Mailing Address - Street 1:401 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-4170
Mailing Address - Country:US
Mailing Address - Phone:814-949-6764
Mailing Address - Fax:814-949-6767
Practice Address - Street 1:11368 WILLIAMSPORT PIKE
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:PA
Practice Address - Zip Code:17225-8531
Practice Address - Country:US
Practice Address - Phone:717-593-4633
Practice Address - Fax:717-593-4632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA232694OtherHIGHMARK
PA39HA34OtherCAPITAL BLUE CROSS
PA1007550730015Medicaid
PA39HA34OtherCAPITAL BLUE CROSS