MEDICARE: NATIONWIDE NURSING 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	30211133	FL

General Provider Information

NPI Number	:	1912193012
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONWIDE NURSING SERVICES, INC.

Provider Business Mailing Address
First Line	:	6320 SAINT AUGUSTINE RD
Second Line	:	SUITE 9
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-2800
Country	:	US
Telephone Number	:	904-731-7772
Fax Number	:	904-419-4990

Provider Business Practice Location Address
First Line	:	6320 SAINT AUGUSTINE RD
Second Line	:	SUITE 9
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-2800
Country	:	US
Telephone Number	:	904-731-7772
Fax Number	:	904-419-4990

Authorized Official
Title or Position	:	CFO
Name	:	MR. PETER J HEBERT
Credential	:
Telephone Number	:	904-731-7772

Provider Enumeration Date	:	09/21/2007
Last Update Date	:	09/21/2007

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