=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346326089
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WHITSYMS LTD INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 E LINTON BLVD 506B
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33483-3327
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-279-0808
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 243578
-----------------------------------------------------
City | BOYNTON BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33424-3578
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-279-0808
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. DONOVAN B ANDERSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 561-279-0808
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | NR30210978
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------