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General NPI Number Information
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NPI Number | 1568712164
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Entity Type | Organization
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Legal Business Name | SOUTHERN HOME HEALTH CARE, INC.
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Dates
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Enumeration Date | 09/12/2012
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 340 49TH ST S
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City | SAINT PETERSBURG
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State | FL
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Zip | 33707-1928
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Country | US
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Telephone | 727-323-4266
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Fax | 727-323-5781
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Provider Business Mailing Address
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Address Line | 340 49TH ST S
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City | SAINT PETERSBURG
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State | FL
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Zip | 33707-1928
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Country | US
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Telephone | 727-323-4266
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Fax | 727-323-5781
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. TRACIE H TURNER
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Credential |
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Telephone | 727-323-4266
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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 | 21079096
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License Number State | FL
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