Healthcare Provider Details

I. General information

NPI: 1962287631
Provider Name (Legal Business Name): DURHAM CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2023
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6404 FARMHILL CT
JACKSONVILLE FL
32218-7389
US

IV. Provider business mailing address

6404 FARMHILL CT
JACKSONVILLE FL
32218-7389
US

V. Phone/Fax

Practice location:
  • Phone: 904-849-5380
  • Fax:
Mailing address:
  • Phone: 904-849-5380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: RAELYN DURHAM
Title or Position: MANAGING MEMBER
Credential: DBA
Phone: 904-849-5380