=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578252615
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PATIENTS FIRST HOME CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2023
-----------------------------------------------------
Last Update Date | 05/04/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4730 SR 64 E UNIT B
-----------------------------------------------------
City | BRADENTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-667-9103
-----------------------------------------------------
Fax | 941-343-8640
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4730 SR 64 E UNIT B
-----------------------------------------------------
City | BRADENTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-667-9103
-----------------------------------------------------
Fax | 941-343-8640
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/CFO
-----------------------------------------------------
Name | TIM T BEACH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 941-232-5050
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------