Healthcare Provider Details

I. General information

NPI: 1932109667
Provider Name (Legal Business Name): XINIM CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1702 RIDGEWOOD AVE SUITE A - G
HOLLY HILL FL
32117-5416
US

IV. Provider business mailing address

1702 RIDGEWOOD AVE SUITE C
HOLLY HILL FL
32117-5416
US

V. Phone/Fax

Practice location:
  • Phone: 386-677-7377
  • Fax: 386-677-0739
Mailing address:
  • Phone: 386-677-7377
  • Fax: 386-677-0739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number299994706
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPH9050
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberPH9050
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberPH9050
License Number StateFL
# 7
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH 9050
License Number StateFL
# 8
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPH9050
License Number State

VIII. Authorized Official

Name: THOMAS HILL
Title or Position: DPT
Credential: PHARMD
Phone: 386-677-7377