Provider Demographics
NPI:1700278884
Name:AG HOME CARE SERVICES
Entity Type:Organization
Organization Name:AG HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:F
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:CRT, RN
Authorized Official - Phone:215-473-2030
Mailing Address - Street 1:1469 N 60TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-4204
Mailing Address - Country:US
Mailing Address - Phone:215-473-2030
Mailing Address - Fax:215-473-2031
Practice Address - Street 1:1469 N 60TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19151-4204
Practice Address - Country:US
Practice Address - Phone:215-473-2030
Practice Address - Fax:215-473-2031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA600854253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care