MEDICARE: RB FISHER HOLDING CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1124638879
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RB FISHER HOLDING CORP

Provider Business Mailing Address
First Line	:	200 9TH AVE N
Second Line	:
City	:	SAFETY HARBOR
State	:	FL
Zip	:	34695-3500
Country	:	US
Telephone Number	:	813-235-4584
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 9TH AVE N
Second Line	:
City	:	SAFETY HARBOR
State	:	FL
Zip	:	34695-3500
Country	:	US
Telephone Number	:	813-235-4584
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JESSE MALIN
Credential	:
Telephone Number	:	813-235-4584

Provider Enumeration Date	:	08/07/2020
Last Update Date	:	08/07/2020

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