Provider Demographics
NPI:1265438733
Name:GUTHRIE HOME CARE
Entity type:Organization
Organization Name:GUTHRIE HOME CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR. DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:570-265-3510
Mailing Address - Street 1:421 TOMAHAWK RD
Mailing Address - Street 2:
Mailing Address - City:TOWANDA
Mailing Address - State:PA
Mailing Address - Zip Code:18848-8327
Mailing Address - Country:US
Mailing Address - Phone:570-265-3510
Mailing Address - Fax:570-265-3570
Practice Address - Street 1:421 TOMAHAWK RD
Practice Address - Street 2:
Practice Address - City:TOWANDA
Practice Address - State:PA
Practice Address - Zip Code:18848-8327
Practice Address - Country:US
Practice Address - Phone:570-265-3510
Practice Address - Fax:570-265-3570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-21
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA712005251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007533730001Medicaid
PA1007533730001Medicaid