Provider Demographics
NPI:1396876595
Name:PARAGON HOME HEALTH CARE CORPORATION
Entity type:Organization
Organization Name:PARAGON HOME HEALTH CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TEK
Authorized Official - Middle Name:NATH
Authorized Official - Last Name:DULAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-602-7564
Mailing Address - Street 1:5600 DERRY ST STE B
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-3518
Mailing Address - Country:US
Mailing Address - Phone:717-727-6327
Mailing Address - Fax:717-525-9946
Practice Address - Street 1:5600 DERRY ST STE B
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-3518
Practice Address - Country:US
Practice Address - Phone:717-727-6327
Practice Address - Fax:717-525-9946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
364SH0200X
PA763805251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015514310001Medicaid
PA397638Medicare Oscar/Certification