123 Pediatric Home Healthcare Corporation
Home Health in Verona, PA. Organization (NPI-2).
NPI number1245696434
StatusActive
Last updated in NPPESApr 18, 2018
Details
- NPI
- 1245696434
- Entity type
- Organization (NPI-2)
- Legal business name
- 123 Pediatric Home Healthcare Corporation
- Organization subpart
- No
- Enumeration date
- Jan 5, 2016
- Last updated
- Apr 18, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251E00000X | Home Health | 06400501 | PA | Yes |
| 1041C0700X | Social Worker, Clinical | CW017087 | PA | |
| 163WG0000X | Registered Nurse, General Practice | RN620599 | PA | |
| 163WH0200X | Registered Nurse, Home Health | RN620599 | PA | |
| 163WI0500X | Registered Nurse, Infusion Therapy | RN620599 | PA | |
| 163WP0200X | Registered Nurse, Pediatrics | RN620599 | PA | |
| 163WP0218X | Registered Nurse, Pediatric Oncology | RN620599 | PA | |
| 163WW0000X | Registered Nurse, Wound Care | RN620599 | PA | |
| 163WX0200X | Registered Nurse, Oncology | RN620599 | PA | |
| 251B00000X | Case Management | 06400501 | PA | |
| 251F00000X | Home Infusion | 06400501 | PA | |
| 251J00000X | Nursing Care | 06400501 | PA | |
| 251J00000X | Nursing Care | RN620599 | PA | |
| 253Z00000X | In Home Supportive Care | 30153601 | PA |
Practice location
6309 Hallwood DrVerona, PA 15147-2526
Phone 412-377-9102
Mailing address
6309 Hallwood DrVerona, PA 15147-2526
Phone 412-377-9102
Authorized official
Lisa Juanita Washington
Chief Executive Officer
4123779102
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