Provider Demographics
NPI:1457394397
Name:ASERACARE HOME HEALTH - PHILADELPHIA, LLC
Entity Type:Organization
Organization Name:ASERACARE HOME HEALTH - PHILADELPHIA, LLC
Other - Org Name:ASERACARE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RASMUSSEN-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-201-4835
Mailing Address - Street 1:690 STOCKTON DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1154
Mailing Address - Country:US
Mailing Address - Phone:601-458-3703
Mailing Address - Fax:
Practice Address - Street 1:690 STOCKTON DR
Practice Address - Street 2:SUITE 100
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1154
Practice Address - Country:US
Practice Address - Phone:601-458-3703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013959840001Medicaid
PA398026Medicare Oscar/Certification