Provider Demographics
NPI:1932555448
Name:D.C. INTERNATIONAL, INC.
Entity Type:Organization
Organization Name:D.C. INTERNATIONAL, INC.
Other - Org Name:AT HOME SENIOR SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:DIETRICH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:412-604-0410
Mailing Address - Street 1:643 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-1523
Mailing Address - Country:US
Mailing Address - Phone:412-604-0410
Mailing Address - Fax:412-264-6054
Practice Address - Street 1:643 5TH AVE
Practice Address - Street 2:
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-1523
Practice Address - Country:US
Practice Address - Phone:412-604-0410
Practice Address - Fax:412-264-6054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-13
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA10483601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1020916510002AMedicaid