Provider Demographics
NPI:1134850910
Name:PIUS, SAMUEL A (DIRECTOR/OWNER)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:A
Last Name:PIUS
Suffix:
Gender:M
Credentials:DIRECTOR/OWNER
Other - Prefix:
Other - First Name:SAMUEL
Other - Middle Name:A
Other - Last Name:PIUS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DIRECTOR/OWNER
Mailing Address - Street 1:2301 TREMONT ST APT F3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-5038
Mailing Address - Country:US
Mailing Address - Phone:484-425-4648
Mailing Address - Fax:
Practice Address - Street 1:2301 TREMONT ST APT F3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-5038
Practice Address - Country:US
Practice Address - Phone:484-425-4648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care