Provider Demographics
NPI:1750384087
Name:PREFERRED HOME HEALTH CARE CORPORATION
Entity type:Organization
Organization Name:PREFERRED HOME HEALTH CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FEDOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-824-9811
Mailing Address - Street 1:328 SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-5535
Mailing Address - Country:US
Mailing Address - Phone:570-824-9811
Mailing Address - Fax:570-821-4519
Practice Address - Street 1:328 SCOTT ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-5535
Practice Address - Country:US
Practice Address - Phone:570-824-9811
Practice Address - Fax:570-821-4519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA7510251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012783590003Medicaid
PA0012783590003Medicaid