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General NPI Number Information
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NPI Number | 1518953579
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Entity Type | Organization
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Legal Business Name | MEDERI OF ALACHUA COUNTY, INC.
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Dates
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Enumeration Date | 09/26/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12106 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-5514
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Country | US
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Telephone | 352-592-1424
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Fax | 352-592-1477
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Provider Business Mailing Address
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Address Line | 9510 ORMSBY STATION RD SUITE 300
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City | LOUISVILLE
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State | KY
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Zip | 40223-4081
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Country | US
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Telephone | 502-891-1000
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Fax | 502-891-8067
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Authorized Official
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Title or Position | SR VP, CFO
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Name | MR. C. STEVEN GUENTHNER
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Credential |
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Telephone | 502-891-1000
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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 | 21822096
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License Number State | FL
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