Provider Demographics
NPI:1922204676
Name:WISE PEOPLES CHOICE OF PENNSYLVANIA, INC
Entity Type:Organization
Organization Name:WISE PEOPLES CHOICE OF PENNSYLVANIA, INC
Other - Org Name:WISE PEOPLES CHOICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:BSNRN
Authorized Official - Phone:215-424-7373
Mailing Address - Street 1:6808 OLD YORK RD
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19126-2842
Mailing Address - Country:US
Mailing Address - Phone:215-424-7373
Mailing Address - Fax:215-424-7399
Practice Address - Street 1:6808 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19126-2842
Practice Address - Country:US
Practice Address - Phone:215-424-7373
Practice Address - Fax:215-424-7399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA763405251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1019613610001Medicaid
PA397634Medicare ID - Type Unspecified