Provider Demographics
NPI:1396436424
Name:WISE HOMECARE INC
Entity type:Organization
Organization Name:WISE HOMECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MANOJ
Authorized Official - Middle Name:
Authorized Official - Last Name:THAKUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-203-6362
Mailing Address - Street 1:5 HUNTERS HILL DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19543-8834
Mailing Address - Country:US
Mailing Address - Phone:855-203-6362
Mailing Address - Fax:
Practice Address - Street 1:525 S 4TH ST STE 245
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-1573
Practice Address - Country:US
Practice Address - Phone:855-203-6362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care