Provider Demographics
NPI:1730898313
Name:KSR HOME CARE SERVICE LLC
Entity type:Organization
Organization Name:KSR HOME CARE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELDAKKAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-649-1941
Mailing Address - Street 1:2617 STREET RD STE 140
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-2864
Mailing Address - Country:US
Mailing Address - Phone:484-649-1941
Mailing Address - Fax:
Practice Address - Street 1:2617 STREET RD STE 140
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-2864
Practice Address - Country:US
Practice Address - Phone:484-649-1941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-22
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health