Provider Demographics
NPI:1962647867
Name:HOMETECH THERAPIES INC
Entity Type:Organization
Organization Name:HOMETECH THERAPIES INC
Other - Org Name:HOMETECH THERAPIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:BARON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:610-368-5443
Mailing Address - Street 1:3200 CONCORD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ASTON
Mailing Address - State:PA
Mailing Address - Zip Code:19014-1931
Mailing Address - Country:US
Mailing Address - Phone:877-586-3816
Mailing Address - Fax:610-364-1305
Practice Address - Street 1:3200 CONCORD RD STE 101
Practice Address - Street 2:
Practice Address - City:ASTON
Practice Address - State:PA
Practice Address - Zip Code:19014-1931
Practice Address - Country:US
Practice Address - Phone:877-586-3816
Practice Address - Fax:610-364-1305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-05
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4818393336C0003X
3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3990505OtherNCPDP PROVIDER IDENTIFICATION NUMBER
PA1025327290001Medicaid