Provider Demographics
NPI:1871227892
Name:MEDICAL HOUSE CALL CLINIC LLC
Entity type:Organization
Organization Name:MEDICAL HOUSE CALL CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED REGISTERED NURSE PRACTITI
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLAH
Authorized Official - Middle Name:C
Authorized Official - Last Name:NOTA
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:610-410-9933
Mailing Address - Street 1:27 GLEN RIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5228
Mailing Address - Country:US
Mailing Address - Phone:610-410-9933
Mailing Address - Fax:360-291-7711
Practice Address - Street 1:27 GLEN RIDDLE RD
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5228
Practice Address - Country:US
Practice Address - Phone:610-410-9933
Practice Address - Fax:360-291-7711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty