Healthcare Provider Details

I. General information

NPI: 1891397907
Provider Name (Legal Business Name): JOHNSON & MULLINGS SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2020
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6412 N UNIVERSITY DR STE 119
TAMARAC FL
33321-4002
US

IV. Provider business mailing address

6412 N UNIVERSITY DR STE 119
TAMARAC FL
33321-4002
US

V. Phone/Fax

Practice location:
  • Phone: 954-804-9376
  • Fax: 954-726-6723
Mailing address:
  • Phone: 954-804-9376
  • Fax: 954-726-6723

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 Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHARON JOHNSON
Title or Position: PRESIDENT
Credential:
Phone: 954-804-9376