MEDICARE: PRECIOUS HEALTH CARE SERVICES 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366922122
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECIOUS HEALTH CARE SERVICES INC.

Provider Business Mailing Address
First Line	:	7003 BROOKLINE AVE
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34951-1232
Country	:	US
Telephone Number	:	772-626-3306
Fax Number	:

Provider Business Practice Location Address
First Line	:	7003 BROOKLINE AVE
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34951-1232
Country	:	US
Telephone Number	:	772-626-3306
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PRECIOUS ALICIA WHITE
Credential	:
Telephone Number	:	772-626-3306

Provider Enumeration Date	:	08/20/2018
Last Update Date	:	08/20/2018

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