NPI 1013530443 · live from the CMS NPI Registry
Distinctive Homecare LLC
Registered Nurse, General Practice in Philadelphia, PA. National Provider Identifier 1013530443, active.
NPI record
| NPI | 1013530443 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Registered Nurse, General Practice 163WG0000X |
| Practice location | 9444 Kirkwood Rd, Philadelphia, PA 19114 |
| Practice phone | 267-815-7307 |
| Enumerated | May 20, 2020 |
| Last updated | May 20, 2020 |
| Authorized official | Benjamin Degraft Koomson, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, General Practice primary | 163WG0000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.