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NPI Code Detail

MEDICARE: TREASURE COAST J -TACS, INC.

MEDICARE: TREASURE COAST J -TACS, 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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1306949276
Entity Type Code : Organization
Provider Name (Legal Business Name) : TREASURE COAST J -TACS, INC.
Provider Business Mailing Address
First Line : PO BOX 3161
Second Line :
City : FORT PIERCE
State : FL
Zip : 34948-3161
Country : US
Telephone Number : 772-940-1800
Fax Number : 772-466-4561
Provider Business Practice Location Address
First Line : 4492 WHISPERING PINES LN
Second Line :
City : FORT PIERCE
State : FL
Zip : 34982-6992
Country : US
Telephone Number : 772-940-1800
Fax Number : 772-466-4561
Authorized Official
Title or Position : PRESIDENT
Name : MR. JAMES EDWARD STRAND
Credential :
Telephone Number : 772-940-1800
Provider Enumeration Date : 09/06/2006
Last Update Date : 08/22/2020

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