Immaculate Mary Home

LBN: Immaculate Mary Home
Immaculate Mary Home is an health care organization with primary practice located at 2990 Holme Ave , Philadelphia PA 19136-1830. The organization recently has only one registered license in Suppliers / Parenteral & Enteral Nutrition, which is considered as the primary health care specialty. Immaculate Mary Home can be contacted via phone (215) 335-2100, or through Czekner, Michael via phone (215) 368-0900.

Contact Information

Primary practice address
2990 Holme Ave Philadelphia PA 19136-1830
Phone: (215) 335-2100
Fax: (215) 368-5254
Website:
Map and Directions
Authorized official contact:
Name: Czekner, Michael
Phone: (215) 368-0900

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Parenteral & Enteral Nutrition 332BP3500X 090902 Pennsylvania

Profile Details

NPI number 1780751115
LBN Legal business name Immaculate Mary Home
DBA Doing business as
Authorized official Czekner, Michael
Entity Organization
Organization subpart 1 No
Enumeration date Nov 29th, 2006
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780751115 NPPES
Other 0649990001 NSC DME SUPPLIER NO

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