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General NPI Number Information
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NPI Number | 1720411622
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE HOME HEALTH SERVICES, CORP.
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Dates
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Enumeration Date | 08/14/2013
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Last Update Date | 08/14/2013
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Provider Practice Location Address
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Address Line | 9010 SW 137TH AVE SUITE 224
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City | MIAMI
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State | FL
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Zip | 33186-1413
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Country | US
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Telephone | 786-615-3821
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Fax | 786-615-3822
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Provider Business Mailing Address
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Address Line | 9010 SW 137TH AVE SUITE 224
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City | MIAMI
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State | FL
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Zip | 33186-1413
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Country | US
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Telephone | 786-615-3821
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Fax | 786-615-3822
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. OSCAR COLLADO
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Credential |
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Telephone | 786-615-3821
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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 |
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License Number State | FL
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