- Enrollment id
- O20070402000058
- Enrollment state
- PA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1992746366
- Multiple npi flag
- N
- Ccn
- 397125
- Associate id
- 0042115008
- Organization name
- PRESBYTERIAN MEDICAL CENTER OF THE UNIVERSITY OF PENNSYLVANIA HEALTH S
- Doing business as name
- PENN MEDICINE HOME HEALTH
- Incorporation date
- 1995-06-13
- Incorporation state
- PA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 150 MONUMENT RD
- Address line 2
- STE 600
- City
- BALA CYNWYD
- State
- PA
- Zip code
- 190041701
- Practice location type
- HHA BRANCH