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General NPI Number Information
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NPI Number | 1871619668
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Entity Type | Organization
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Legal Business Name | BAPTIST HOME CARE
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 11/04/2008
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Provider Practice Location Address
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Address Line | 3563 PHILIPS HWY BLD 202, SUITE 202
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City | JACKSONVILLE
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State | FL
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Zip | 32207
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Country | UM
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Telephone | 904-202-4341
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Fax |
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Provider Business Mailing Address
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Address Line | 3563 PHILLIPS HWY SUITE 202 BLD B
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City | JACKSONVILLE
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State | FL
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Zip | 32207-5663
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Country | US
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Telephone | 904-202-4341
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | JANICE ROGERS
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Credential | R.PH
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Telephone | 904-202-4331
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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 |
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