PA Care Alliance LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PA CARE ALLIANCE LLC

Practice address

301 Heights LN Apt 40C
Feasterville Trevose, PA 19053-7650

Phone

(267) 265-6082

NPI assigned

Sep 14, 2020

Last updated

Sep 14, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bogdan Degterenko

Title

President

Phone

(267) 265-6082

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600041600000",
    "number": "1881209088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HEIGHTS LN APT 40C",
            "city": "FEASTERVILLE TREVOSE",
            "state": "PA",
            "postal_code": "190537650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HEIGHTS LN APT 40C",
            "city": "FEASTERVILLE TREVOSE",
            "state": "PA",
            "postal_code": "190537650",
            "telephone_number": "267-265-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PA CARE ALLIANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A",
        "authorized_official_last_name": "DEGTERENKO",
        "authorized_official_first_name": "BOGDAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "267-265-6082"
    },
    "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": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.