Blue Water Home Care

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

BLUE WATER HOME CARE

Doing business as

Right at Home Main Line

Practice address

111 Carlton PL
Media, PA 19063-2105

Phone

(215) 385-4275

NPI assigned

Apr 24, 2023

Organization subpart

No

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

Authorized official

Name

Theodore George Pease

Title

Owner

Phone

(215) 385-4275

Specialties & licenses 1

Addresses

Other names 1

• Right at Home Main Line Doing business as

Locations

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1962199414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4128 DAISY LN",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621520",
            "telephone_number": "215-385-4275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CARLTON PL",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190632105",
            "telephone_number": "215-385-4275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WATER HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "PEASE",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-385-4275"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Right at Home Main Line",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Blank, PHARMD
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• Samantha Bluj, RD, LDN
• Edan Blumenthal, DMD
• Jordan Scott Blumenthal, DMD
• Mary Ann Blumenthal, PSYD
• Max Harley Blumenthal, DDS

• In Home Supportive Care Agency in Media, PA
• Providers in Media, 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 Apr 24, 2023; 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.