Healthcare Provider Details

I. General information

NPI: 1164284600
Provider Name (Legal Business Name): EMPIRE HOME CARE OF SOUTH FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2024
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1691 FORUM PL B PMB 1142
WEST PALM BEACH FL
33401
US

IV. Provider business mailing address

1691 FORUM PL B PMB 1142
WEST PALM BEACH FL
33401
US

V. Phone/Fax

Practice location:
  • Phone: 561-847-5565
  • Fax:
Mailing address:
  • Phone: 561-847-5565
  • 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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: ANNETTE CAMPBELL
Title or Position: CEO
Credential:
Phone: 561-847-5565