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General NPI Number Information
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NPI Number | 1659381135
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Entity Type | Organization
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Legal Business Name | EXTRA CARE HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9002 W HILLSBOROUGH AVE
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City | TAMPA
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State | FL
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Zip | 33615-3717
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Country | US
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Telephone | 813-901-0236
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Fax | 813-901-0236
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Provider Business Mailing Address
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Address Line | 7005 PELICAN ISLAND DR
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City | TAMPA
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State | FL
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Zip | 33634-7422
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Country | US
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Telephone | 813-205-8536
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Fax | 813-882-3589
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | MR. JAMES W. EYER JR.
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Credential |
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Telephone | 813-205-8536
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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 | G06074900030
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License Number State | FL
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