Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 251G00000X | Hospice Care, Community Based | | 07391600 | PENNSYLVANIA | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 20007398 | OTHER | | AMERIHEALTH HEALTH PLANS |
| 2 | 20007398 | OTHER | | HEALTHCARE DELAWARE, INC |
| 3 | 0003403000 | OTHER | | KEYSTONE HEALTH PLAN EAST |
| 4 | 20007398 | OTHER | | AMERIHEALTH ADMIN INC |
| 5 | 391515 | OTHER | | KEYSTONE HEALTH PLAN |
| 6 | 64297 | OTHER | | AETNA |
| 7 | 20007398 | OTHER | | AMERIHEALTH MERCY HEALTH |
| 8 | 1007575790004 | MEDICAID | PENNSYLVANIA | |
| 9 | 1512954 | OTHER | | GATEWAY HEALTH PLAN |
| 10 | 20007398 | OTHER | | INTER-COUNTY HEALTH PLAN |
| 11 | 0135 | OTHER | | HIGHMARK BLUE SHIELD |
| 12 | 20007398 | OTHER | NEW JERSEY | AMERIHEALTH INSURANCE CO |
| 13 | 391515 | OTHER | | CAPITAL BLUE CROSS |
| 14 | 702780 | OTHER | | FEDERAL BLACK LUNG |
