Provider Demographics
NPI:1235933136
Name:COSMIC HOME CARE LLC
Entity type:Organization
Organization Name:COSMIC HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:SARDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASSELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:856-536-7575
Mailing Address - Street 1:1501 OLD BLACK HORSE PIKE APT L9
Mailing Address - Street 2:
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-4932
Mailing Address - Country:US
Mailing Address - Phone:856-536-7575
Mailing Address - Fax:
Practice Address - Street 1:1874 MARLTON PIKE E STE 7
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2039
Practice Address - Country:US
Practice Address - Phone:856-537-9003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care