Provider Demographics
NPI:1023751096
Name:MOON HOME CARE AGENCY INC.
Entity type:Organization
Organization Name:MOON HOME CARE AGENCY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADIL
Authorized Official - Middle Name:
Authorized Official - Last Name:AL HASHIMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-393-2233
Mailing Address - Street 1:16 APRICOT LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19055-1220
Mailing Address - Country:US
Mailing Address - Phone:267-393-2233
Mailing Address - Fax:
Practice Address - Street 1:16 APRICOT LN
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19055-1220
Practice Address - Country:US
Practice Address - Phone:267-393-2233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care