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IMMACULATE MARY HOME
NPI 1780751115
Durable Medical Equipment & Medical Supplies - Parenteral & Enteral Nutrition in Philadelphia, PA

Active since November 29, 2006
2990 HOLME AVE, PHILADELPHIA, PA 19136(215) 335-2100(215) 368-5254 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Immaculate Mary Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IMMACULATE MARY HOME (NPI 1780751115) is a healthcare organization registered as a parenteral & enteral nutrition in Philadelphia, Pennsylvania and active in the NPI registry since November 2006. The organization lists Michael Czekner, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1780751115
Entity TypeOrganization
Primary Taxonomy332BP3500X
Legal Business NameIMMACULATE MARY HOME
Location Address2990 HOLME AVEPhiladelphia, PA 19136-1830
Mailing Address2990 Holme AvePhiladelphia, PA 19136-1830 · (215) 335-2100 · Fax (215) 368-5254
Phone(215) 335-2100
Fax(215) 368-5254
Organization SubpartNo
Authorized OfficialMichael CzeknerChief Financial Officer · (215) 368-0900
Enumeration DateNovember 29, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1780751115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical Supplies · Parenteral & Enteral NutritionSuppliers
Taxonomy Code332BP3500X
License✔ Licensed in PA · 090902
2990 HOLME AVE, Philadelphia, PA 19136
Open in Google Maps ↗

Other Identifiers 1

Other0649990001Nsc Dme Supplier No

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DONNA GAYHART KEPPOL PT
Physical Therapist
2990 HOLME AVE
PHILADELPHIA, PA 19136
Philadelphia County (215) 335-2100
KIMBERLY JASTRZEMBSKI
Physical Therapist
2990 HOLME AVE
PHILADELPHIA, PA 19136
Philadelphia County (215) 992-1862
BARBARA OLEJNIK OT
Occupational Therapist
2990 HOLME AVE, IMMACULATE MARY HOME
PHILADELPHIA, PA 19136
Philadelphia County (215) 992-1861
AVERY HARRIS
Speech-Language Pathologist
2990 HOLME AVE, IMMACULATE MARY HOME
PHILADELPHIA, PA 19136
Philadelphia County (215) 992-1860
MR. JOSEPH WILLIAM VERSCHELDE P.T. A.
Physical Therapy Assistant
2990 HOLME AVE, IMMACULATE MARY HOME
PHILADELPHIA, PA 19136
Philadelphia County (215) 992-1861
2990 HOLME OPERATING, LLC
Skilled Nursing Facility
2990 HOLME AVE
PHILADELPHIA, PA 19136
Philadelphia County (215) 335-2100
IMMACULATE MARY HOME
Skilled Nursing Facility
2990 HOLME AVE
PHILADELPHIA, PA 19136
Philadelphia County (215) 335-2100
SEAN KAROTT
Physical Medicine & Rehabilitation
2990 HOLME AVE
PHILADELPHIA, PA 19136
Philadelphia County (201) 654-6397

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Immaculate Mary Home's NPI number?

The NPI number for Immaculate Mary Home is 1780751115. It was assigned to this organization in the NPPES registry on November 29, 2006.

Where is Immaculate Mary Home located?

Immaculate Mary Home is located at 2990 Holme Ave, Philadelphia, PA 19136. The listed phone number is (215) 335-2100.

What is Immaculate Mary Home's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies, specializing in Parenteral & Enteral Nutrition, with taxonomy code 332BP3500X.

When was this NPI record last updated?

The NPPES record for Immaculate Mary Home was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.