Provider Demographics
NPI:1144265679
Name:AT HOME INC
Entity type:Organization
Organization Name:AT HOME INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:STONICH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:610-820-8301
Mailing Address - Street 1:4315 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SCHNECKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18078-2002
Mailing Address - Country:US
Mailing Address - Phone:610-820-8301
Mailing Address - Fax:267-319-1531
Practice Address - Street 1:4315 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SCHNECKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18078-2002
Practice Address - Country:US
Practice Address - Phone:610-820-8301
Practice Address - Fax:267-319-1531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208D00000X
PA02760501251E00000X
PA17481601251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1018007450001Medicaid
PA02760501OtherHEALTH CARE FACILITY LIC.
PA02760501OtherHEALTH CARE FACILITY LIC.
PA391748Medicare Oscar/Certification
PA391748Medicare Oscar/Certification