Provider Demographics
NPI:1669126983
Name:KOFMA HOME CARE INC
Entity type:Organization
Organization Name:KOFMA HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASAMOAH
Authorized Official - Middle Name:T
Authorized Official - Last Name:KUFFUOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-272-2559
Mailing Address - Street 1:208 HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-3955
Mailing Address - Country:US
Mailing Address - Phone:215-272-2559
Mailing Address - Fax:
Practice Address - Street 1:208 HERITAGE DR
Practice Address - Street 2:
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-3955
Practice Address - Country:US
Practice Address - Phone:215-272-2559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-06
Last Update Date:2022-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA62653601Medicaid