Individual ProviderTara CarachiloFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address10800 Knights Rd, Philadelphia, PA 19114-4200(215) 612-5161PECOS EnrollmentBased on the most recent information from CMS, provider Tara Carachilo is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records today at 11:35 AM.Profile DetailsProvider ID1720648173Provider TypeIndividualFull NameCarachilo, TaraTitleDr.CredentialDOGenderFemaleSole ProprietorNoEnumeration Date6/18/2019Last Updated7/15/2024Contact InformationPractice LocationPractice Address10800 Knights Rd, Philadelphia, PA 19114-4200Phone(215) 612-5161FaxUnlisted FaxMailing LocationMailing Address10800 Knights Rd, Philadelphia, PA 19114-4200Phone(215) 612-5161FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseOS021582PennsylvaniaCode207P00000XDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicenseOS021582PennsylvaniaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseOT019490Pennsylvania