Healthcare Provider Details

I. General information

NPI: 1962742635
Provider Name (Legal Business Name): NURTEC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2013
Last Update Date: 02/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 PINELLAS PL
TAMPA FL
33619-6539
US

IV. Provider business mailing address

3201 PINELLAS PL
TAMPA FL
33619-6539
US

V. Phone/Fax

Practice location:
  • Phone: 813-443-4393
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIE B GREEN SR.
Title or Position: OWNER
Credential:
Phone: 813-443-4393