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General NPI Number Information
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NPI Number | 1073840658
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Entity Type | Organization
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Legal Business Name | RUSSELL KROL ENTERPRISES, INC.
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Dates
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Enumeration Date | 11/03/2009
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Last Update Date | 11/03/2009
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Provider Practice Location Address
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Address Line | 1799 N BELCHER RD STE B
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City | CLEARWATER
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State | FL
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Zip | 33765-1324
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Country | US
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Telephone | 727-799-1400
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Fax | 727-799-3958
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Provider Business Mailing Address
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Address Line | 1799 N BELCHER RD STE B
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City | CLEARWATER
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State | FL
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Zip | 33765-1324
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Country | US
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Telephone | 727-799-1400
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Fax | 727-799-3958
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. JULIE ANN KROL
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Credential |
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Telephone | 727-799-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 229862
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License Number State | ZZ
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