Immaculate Mary Home
Parenteral & Enteral Nutrition
2990 Holme Ave, Philadelphia
Pennsylvania, 19136-1830
215-335-2100 215-368-5254
Immaculate Mary Home is a Parenteral & Enteral Nutrition in Philadelphia, Pennsylvania. It is located at 2990 Holme Ave, Philadelphia and it's customer support contact number is 215-335-2100. The authorized person of Immaculate Mary Home is Mr. Michael Czekner who is Chief Financial Officer of this DME and his contact number is 215-368-0900. Active license number of Immaculate Mary Home is 090902 for Parenteral & Enteral Nutrition in Pennsylvania.
Immaculate Mary Home is a medical supplier who supplies medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
DME Supplier Details:
Immaculate Mary Home type, location, contact phone number and fax are as below. Patients can directly walkin or can call on the below given customer support phone number for enquiries.
| Name: | Immaculate Mary Home |
| Type: | Parenteral & Enteral Nutrition |
| Location: | 2990 Holme Ave, Philadelphia,
Pennsylvania, 19136-1830 |
| Phone: | 215-335-2100 |
| Fax: | 215-368-5254 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this supplier is as below. Person's position and contact details are also mentioned below.
| Name: | Mr. Michael Czekner |
| Position: | Chief Financial Officer |
| Contact Number: | 215-368-0900 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given supplier are as mentioned below.
| NPI Number: | 1780751115 |
| NPI Enumeration Date: | 29 Nov, 2006 |
| NPI Last Update On: | 22 Aug, 2020 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Immaculate Mary Home are as mentioned below.
| Specialization | License Number | State | Status | |
| Parenteral & Enteral Nutrition | 090902 | Pennsylvania | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of this supplier such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 0649990001 | Other | | Nsc Dme Supplier No |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 2990 Holme Ave,
Philadelphia, Pennsylvania |
| Zip: | 19136-1830 |
| Phone Number: | 215-335-2100 |
| Fax Number: | 215-368-5254 |
Patients can reach Immaculate Mary Home at
2990 Holme Ave, Philadelphia, Pennsylvania or can
call on customer care at 215-335-2100.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.