Provider Demographics
NPI:1669065074
Name:HERITAGE CARE
Entity type:Organization
Organization Name:HERITAGE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHUKWUFUMNANYA
Authorized Official - Middle Name:I
Authorized Official - Last Name:EKHATOR
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:267-949-6789
Mailing Address - Street 1:100 E GLENOLDEN AVE STE B21
Mailing Address - Street 2:
Mailing Address - City:GLENOLDEN
Mailing Address - State:PA
Mailing Address - Zip Code:19036-2208
Mailing Address - Country:US
Mailing Address - Phone:215-882-4949
Mailing Address - Fax:
Practice Address - Street 1:923 HADDONFIELD RD # 324
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2752
Practice Address - Country:US
Practice Address - Phone:856-324-8273
Practice Address - Fax:215-310-4956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care