C3 Solutions Home Healthcare PHL, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

C3 SOLUTIONS HOME HEALTHCARE PHL, LLC

Practice address

352 E Wister St
Philadelphia, PA 19144-1856

Phone

(445) 252-4664

NPI assigned

Feb 20, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Derek ClarkNPI 1497469480

Title

Ceo

Phone

(445) 252-4664

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Derek Anthony Clark

  • Case Manager/Care Coordinator
  • Philadelphia, PA
  • NPI 1497469480
  NPD Authorized official

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708387200000",
    "number": "1639934581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 E WISTER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191441856",
            "telephone_number": "445-252-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 E WISTER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191441856",
            "telephone_number": "445-252-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C3 SOLUTIONS HOME HEALTHCARE PHL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "445-252-4664",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Feb 20, 2024; 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.