Healthcare Provider Details

I. General information

NPI: 1609793553
Provider Name (Legal Business Name): WOREDOX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4128 ANDOVER ST
NEW PORT RICHEY FL
34653-6203
US

IV. Provider business mailing address

4128 ANDOVER ST
NEW PORT RICHEY FL
34653-6203
US

V. Phone/Fax

Practice location:
  • Phone: 929-410-5754
  • Fax: 929-410-5754
Mailing address:
  • Phone: 929-410-5754
  • Fax: 929-410-5754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CHARLES JACKSON
Title or Position: CEO
Credential:
Phone: 929-410-5754