Provider Demographics
NPI:1023088093
Name:GEM HOME CARE, INC.
Entity type:Organization
Organization Name:GEM HOME CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:YELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARMUR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:215-396-4950
Mailing Address - Street 1:55 BUCK RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-1501
Mailing Address - Country:US
Mailing Address - Phone:215-396-4950
Mailing Address - Fax:215-396-6650
Practice Address - Street 1:55 BUCK RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-1501
Practice Address - Country:US
Practice Address - Phone:215-396-4950
Practice Address - Fax:215-396-6650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA391668251G00000X
PA397766251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001888993002Medicaid
391668Medicare Oscar/Certification
PA397766Medicare ID - Type Unspecified