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General NPI Number Information
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NPI Number | 1699283325
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Entity Type | Organization
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Legal Business Name | HOLCAM LLC
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Dates
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Enumeration Date | 01/16/2018
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Last Update Date | 06/17/2020
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Provider Practice Location Address
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Address Line | 25166 MARION AVE UNIT 114
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City | PUNTA GORDA
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State | FL
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Zip | 33950-4017
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Country | US
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Telephone | 941-347-8288
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Fax | 888-547-2557
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Provider Business Mailing Address
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Address Line | 25166 MARION AVE UNIT 114
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City | PUNTA GORDA
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State | FL
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Zip | 33950-4017
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Country | US
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Telephone | 941-347-8288
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Fax | 888-547-2557
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | SUNNY CAVANAUGH
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Credential |
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Telephone | 941-347-8288
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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 | 302114657
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 299994657
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License Number State | FL
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