Healthcare Provider Details

I. General information

NPI: 1245859586
Provider Name (Legal Business Name): HB SUPPORT SERVICES GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 04/15/2020
Certification Date: 04/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 S ARAGON BLVD
SUNRISE FL
33322-3140
US

IV. Provider business mailing address

1830 N UNIVERSITY DR # 138
PLANTATION FL
33322-4114
US

V. Phone/Fax

Practice location:
  • Phone: 954-901-4626
  • Fax:
Mailing address:
  • Phone: 954-901-4626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: HERCHELLA BAYNES
Title or Position: DIRECTOR
Credential:
Phone: 954-901-4626