Provider Demographics
NPI:1750001301
Name:TOM BARNES MBORI HEALTH SERVICES LLC
Entity type:Organization
Organization Name:TOM BARNES MBORI HEALTH SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:ALEXANDRIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WHITLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:302-353-9341
Mailing Address - Street 1:2401 PENNSYLVANIA AVE STE 1A10
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-3002
Mailing Address - Country:US
Mailing Address - Phone:267-324-3985
Mailing Address - Fax:610-514-2535
Practice Address - Street 1:2401 PENNSYLVANIA AVE STE 1A10
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-3002
Practice Address - Country:US
Practice Address - Phone:267-324-3985
Practice Address - Fax:610-514-2535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-01
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health