Healthcare Provider Details

I. General information

NPI: 1366959611
Provider Name (Legal Business Name): GOLDEN ARC HOMECARE SOLUTION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2018
Last Update Date: 10/04/2021
Certification Date: 10/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

196 E NINE MILE RD STE D
PENSACOLA FL
32534-3119
US

IV. Provider business mailing address

PO BOX 845
GONZALEZ FL
32560-0845
US

V. Phone/Fax

Practice location:
  • Phone: 850-525-0696
  • Fax: 850-525-0696
Mailing address:
  • Phone: 850-525-0696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number299994727
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. TIFFANY DANILLIE ROGERS
Title or Position: CEO
Credential:
Phone: 850-525-0696