Provider Demographics
NPI:1205314663
Name:HIMALI HOME CARE
Entity type:Organization
Organization Name:HIMALI HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KISHOR
Authorized Official - Middle Name:
Authorized Official - Last Name:PRADHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-602-6283
Mailing Address - Street 1:243 RUTHERGLEN DR
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15071-9734
Mailing Address - Country:US
Mailing Address - Phone:724-307-3531
Mailing Address - Fax:
Practice Address - Street 1:243 RUTHERGLEN DR
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:PA
Practice Address - Zip Code:15071-9734
Practice Address - Country:US
Practice Address - Phone:724-307-3531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-29
Last Update Date:2018-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6708019OtherCOMMONWEALTH OF PENNSYLVANIA