Provider Demographics
NPI:1457699977
Name:SYNERGY HOMECARE
Entity Type:Organization
Organization Name:SYNERGY HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMENIMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-265-2350
Mailing Address - Street 1:450 PARKWAY
Mailing Address - Street 2:SUITE C
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-4202
Mailing Address - Country:US
Mailing Address - Phone:610-265-2350
Mailing Address - Fax:610-265-2581
Practice Address - Street 1:450 PARKWAY
Practice Address - Street 2:SUITE C
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-4202
Practice Address - Country:US
Practice Address - Phone:610-265-2350
Practice Address - Fax:610-265-2581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA11913601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health