Provider Demographics
NPI:1881869964
Name:BRANDYWINE SENIOR CARE,LLC
Entity type:Organization
Organization Name:BRANDYWINE SENIOR CARE,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:MULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-358-1640
Mailing Address - Street 1:1204 BALTIMORE PIKE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-7373
Mailing Address - Country:US
Mailing Address - Phone:610-358-1640
Mailing Address - Fax:
Practice Address - Street 1:1204 BALTIMORE PIKE
Practice Address - Street 2:SUITE 301
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-7373
Practice Address - Country:US
Practice Address - Phone:610-358-1640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019496960002Medicaid
PA0019496960001Medicaid