MEDICARE: PRIVATE CARE INC

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	HHA20963095	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	H5T	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215087838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIVATE CARE INC

Provider Business Mailing Address
First Line	:	580 VILLAGE BLVD STE 270
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-1904
Country	:	US
Telephone Number	:	561-616-2715
Fax Number	:	561-684-2332

Provider Business Practice Location Address
First Line	:	580 VILLAGE BLVD STE 270
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-1904
Country	:	US
Telephone Number	:	561-616-2715
Fax Number	:	561-684-2332

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MRS. THAMARVA L MITCHELL-LEGETTE
Credential	:
Telephone Number	:	561-616-2715

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	08/22/2020

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Directions to “PRIVATE CARE INC ” Practice Location

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