Provider Demographics
NPI:1487057501
Name:GOLDEN BOW-TY HOME HEALTH & COMPANION CARE
Entity type:Organization
Organization Name:GOLDEN BOW-TY HOME HEALTH & COMPANION CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFONSO
Authorized Official - Middle Name:
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:215-904-5184
Mailing Address - Street 1:3103 PHILMONT AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-4263
Mailing Address - Country:US
Mailing Address - Phone:215-904-5184
Mailing Address - Fax:866-892-9294
Practice Address - Street 1:3103 PHILMONT AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-4263
Practice Address - Country:US
Practice Address - Phone:215-904-5184
Practice Address - Fax:866-892-9294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-02
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA25763601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health