Provider Demographics
NPI:1700884459
Name:SANDIN HOME HEALTH SERVICES,INC
Entity Type:Organization
Organization Name:SANDIN HOME HEALTH SERVICES,INC
Other - Org Name:SANDIN HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:DEBORAH
Authorized Official - Last Name:PACACHA
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:412-816-2325
Mailing Address - Street 1:1119 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:EAST MC KEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15035-1517
Mailing Address - Country:US
Mailing Address - Phone:412-816-2325
Mailing Address - Fax:412-816-2321
Practice Address - Street 1:1119 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:EAST MC KEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15035-1517
Practice Address - Country:US
Practice Address - Phone:412-816-2325
Practice Address - Fax:412-816-2321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA771405251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
397714Medicare ID - Type Unspecified