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General NPI Number Information
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NPI Number | 1841689718
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Entity Type | Organization
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Legal Business Name | EMERALD COAST HOME CARE, INC.
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 2101 NORTHSIDE DR UNIT 304
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City | PANAMA CITY
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State | FL
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Zip | 32405-3686
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Country | US
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Telephone | 850-215-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 NORTHSIDE DR UNIT 304
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City | PANAMA CITY
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State | FL
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Zip | 32405-3686
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Country | US
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Telephone | 850-215-3300
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIAN MACK
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Credential |
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Telephone | 850-215-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 30211753
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License Number State | FL
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