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General NPI Number Information
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NPI Number | 1235551862
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Entity Type | Organization
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Legal Business Name | GREYSTONE HOME HEALTHCARE OF GREATER TAMPA BAY LLC
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Dates
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Enumeration Date | 01/16/2014
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Last Update Date | 01/16/2014
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Provider Practice Location Address
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Address Line | 3780 TAMPA RD SUITE 205
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City | OLDSMAR
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State | FL
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Zip | 34677-3041
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Country | US
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Telephone | 813-814-1343
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Fax |
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Provider Business Mailing Address
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Address Line | 3780 TAMPA RD SUITE 205
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City | OLDSMAR
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State | FL
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Zip | 34677-3041
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Country | US
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Telephone | 813-814-1343
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT AND CFO
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Name | RON SWARTZ
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Credential |
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Telephone | 813-675-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 299993666
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License Number State | FL
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