Healthcare Provider Details

I. General information

NPI: 1093244568
Provider Name (Legal Business Name): HOME-CALL HEALTHCARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7235 BONNEVAL RD STE 404
JACKSONVILLE FL
32256-7506
US

IV. Provider business mailing address

7235 BONNEVAL RD STE 404
JACKSONVILLE FL
32256-7506
US

V. Phone/Fax

Practice location:
  • Phone: 904-861-0424
  • Fax: 904-861-0428
Mailing address:
  • Phone: 904-861-0424
  • Fax: 904-861-0428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number30211822
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number30211822
License Number StateFL

VIII. Authorized Official

Name: MRS. LINDA ANN OCONNOR
Title or Position: ADMINISTRATOR
Credential: R.N.
Phone: 904-861-0424