Provider Demographics
NPI:1942022314
Name:PAX-ANCORA HOME CARE AGENCY LLC
Entity type:Organization
Organization Name:PAX-ANCORA HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARTHOLOMEW
Authorized Official - Middle Name:
Authorized Official - Last Name:UCHE-EJEKWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-467-4584
Mailing Address - Street 1:1616 MEGAN DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46074-8702
Mailing Address - Country:US
Mailing Address - Phone:240-467-4584
Mailing Address - Fax:
Practice Address - Street 1:1616 MEGAN DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46074-8702
Practice Address - Country:US
Practice Address - Phone:240-467-4584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care