Provider Demographics
NPI:1841401890
Name:INTERIM HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ZESHONSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-883-9773
Mailing Address - Street 1:115 NEW ST
Mailing Address - Street 2:
Mailing Address - City:HUGHESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18640-2148
Mailing Address - Country:US
Mailing Address - Phone:570-883-9773
Mailing Address - Fax:570-883-9779
Practice Address - Street 1:115 NEW ST
Practice Address - Street 2:
Practice Address - City:HUGHESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18640-2148
Practice Address - Country:US
Practice Address - Phone:570-883-9773
Practice Address - Fax:570-883-9779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA745705235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA397457Medicare ID - Type Unspecified