Healthcare Provider Details

I. General information

NPI: 1659878676
Provider Name (Legal Business Name): PROFESSIONAL HEALTH CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2018
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5620 CHERRY ST STE B
PANAMA CITY FL
32404-6766
US

IV. Provider business mailing address

14965 STATE HIGHWAY 59 STE 102
FOLEY AL
36535-2471
US

V. Phone/Fax

Practice location:
  • Phone: 850-563-7853
  • Fax:
Mailing address:
  • Phone: 251-947-5593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. LISA J WELLS
Title or Position: VP
Credential:
Phone: 205-221-8258