Provider Demographics
NPI:1053097758
Name:POCONO MOUNTAINS PALLIATIVE HOSPICE & HOMEHEALTH CARE INC
Entity type:Organization
Organization Name:POCONO MOUNTAINS PALLIATIVE HOSPICE & HOMEHEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAYMND
Authorized Official - Middle Name:
Authorized Official - Last Name:OBIAMALU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-705-6028
Mailing Address - Street 1:306 S NEW ST STE 110
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1110
Mailing Address - Country:US
Mailing Address - Phone:626-705-6028
Mailing Address - Fax:909-266-0334
Practice Address - Street 1:306 S NEW ST STE 110
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1110
Practice Address - Country:US
Practice Address - Phone:626-705-6028
Practice Address - Fax:909-266-0334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based