MEDICARE: EXCELLENCE IN HOME 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		FL

General Provider Information

NPI Number	:	1912170879
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCELLENCE IN HOME CARE, INC.

Provider Business Mailing Address
First Line	:	3418 HANDY RD STE 104
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-4603
Country	:	US
Telephone Number	:	813-264-6500
Fax Number	:	813-264-6543

Provider Business Practice Location Address
First Line	:	3418 HANDY RD STE 104
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-4603
Country	:	US
Telephone Number	:	813-264-6500
Fax Number	:	813-264-6543

Authorized Official
Title or Position	:	ADMINISTRATOR/OWNER
Name	:	MRS. DEBORAH C PITTMAN
Credential	:	RN
Telephone Number	:	813-264-6500

Provider Enumeration Date	:	04/10/2008
Last Update Date	:	04/10/2008

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