=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073834651
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DENBAR HOME HEALTH AGENCY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/17/2010
-----------------------------------------------------
Last Update Date | 06/17/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6102 MIRAMAR PARKWAY
-----------------------------------------------------
City | MIRAMAR
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33023
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-966-4884
-----------------------------------------------------
Fax | 954-966-8448
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6102 MIRAMAR PARKWAY
-----------------------------------------------------
City | MIRAMAR
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33023
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-966-4884
-----------------------------------------------------
Fax | 954-966-8448
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MRS. BARBARA PATRICIA DOYLEY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 954-966-4884
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 299991781
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------