1St Independence LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

1ST INDEPENDENCE LLC

Practice address

3314 N Bouvier St
Philadelphia, PA 19140-4921

Phone

(215) 278-9237

NPI assigned

Oct 26, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jadan Monae Randolph

Title

Owner

Phone

(856) 813-6379

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625616000000",
    "number": "1083213573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3314 N BOUVIER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404921",
            "telephone_number": "215-278-9237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3314 N BOUVIER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404921",
            "telephone_number": "215-278-9237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1ST INDEPENDENCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-26",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A",
        "authorized_official_last_name": "RANDOLPH",
        "authorized_official_first_name": "JADAN",
        "authorized_official_middle_name": "MONAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-813-6379"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 1526 Lombard Street SNF Operations II LLC
• 184 Bethlehem Pike Operations LLC
• 1St Aid Medical Co.
• 1St Choice Home Health Care-PA, LLC.
• 1St Choice Inc
• 1St United Home Health Care, LLC
• 2 Caring Hands Home Health Care Inc
• 2000 SG Associates PC
• 2126 Fairmount Medical, Inc.
• 2157627000

• In Home Supportive Care Agency in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• In Home Supportive Care Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.