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General NPI Number Information
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NPI Number | 1689878035
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Entity Type | Organization
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Legal Business Name | ADMIRAL HOME HEALTH INC.
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2504 WASHINGTON ST SUITE 201-5
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City | WAUKEGAN
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State | IL
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Zip | 60085-4983
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Country | US
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Telephone | 847-410-8750
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Fax | 847-655-2709
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Provider Business Mailing Address
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Address Line | 2504 WASHINGTON ST SUITE 201-5
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City | WAUKEGAN
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State | IL
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Zip | 60085-4983
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Country | US
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Telephone | 847-410-8750
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Fax | 847-655-2709
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Authorized Official
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Title or Position | AGENCY SUPERVISOR
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Name | MS. MARILYN AZCONA
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Credential | RN
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Telephone | 847-410-8750
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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 | 1010623
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License Number State | IL
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