Provider Demographics
NPI:1538734512
Name:K. MADISON CARES LLC
Entity type:Organization
Organization Name:K. MADISON CARES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-972-3280
Mailing Address - Street 1:4418 N 15TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-1927
Mailing Address - Country:US
Mailing Address - Phone:267-972-3280
Mailing Address - Fax:
Practice Address - Street 1:4418 N 15TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-1927
Practice Address - Country:US
Practice Address - Phone:267-972-3280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-23
Last Update Date:2021-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA54003601OtherPA DEPT OF HEALTH HCA LICENSE NUMBER