Provider Demographics
NPI:1205131216
Name:FEBO COMPANY
Entity type:Organization
Organization Name:FEBO COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:MICHAILOVICH
Authorized Official - Last Name:ZVENIGORODSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-255-9538
Mailing Address - Street 1:162 LARKSPUR PL
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-2704
Mailing Address - Country:US
Mailing Address - Phone:215-676-1948
Mailing Address - Fax:
Practice Address - Street 1:162 LARKSPUR PL
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-2704
Practice Address - Country:US
Practice Address - Phone:215-676-1948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA11563601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care