MEDICARE: GREATER FELLOWSHIP MINISTRIES 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	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1770393290
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREATER FELLOWSHIP MINISTRIES INC.

Provider Business Mailing Address
First Line	:	3912 E CLIFTON ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-3749
Country	:	US
Telephone Number	:	813-475-0665
Fax Number	:

Provider Business Practice Location Address
First Line	:	3912 E CLIFTON ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-3749
Country	:	US
Telephone Number	:	813-475-0665
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ANTONIO OWENS
Credential	:
Telephone Number	:	813-475-0665

Provider Enumeration Date	:	01/08/2025
Last Update Date	:	01/08/2025

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