IndividualActive
Augie Wallace
NPI 1083083455 · Home Health Aide · Upper Darby, PA
Provider details
- NPI number
- 1083083455
- Entity type
- Individual
- Primary specialty
- Home Health AideNursing Service Related Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 28613601 (PA)
Specialties & taxonomies
Nursing Service Related Providers
Practice location
8600 W Chester Pike Ste 308
Upper Darby, PA 19082-2629
Phone: (484) 433-8208
Approximate (ZIP-level) locationGet directions
Mailing address
4312 Main St Apt 316
Philadelphia, PA 19127-1531
Registry dates
- Enumerated
- 2015-09-16
- Last updated
- 2021-09-13
- Certified
- 2021-09-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.