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General NPI Number Information
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NPI Number | 1912233628
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Entity Type | Organization
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Legal Business Name | UNIVITA OF GEORGIA LLC
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Dates
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Enumeration Date | 10/30/2009
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Last Update Date | 05/24/2010
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Provider Practice Location Address
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Address Line | 3700 COMMERCE PKWY SUITE A
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City | MIRAMAR
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State | FL
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Zip | 33025-3912
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Country | US
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Telephone | 952-516-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 11000 PRAIRIE LAKES DR SUITE 600
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-3885
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Country | US
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Telephone | 952-516-6800
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT AND TREASURER
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Name | MR. JEFF SJOBECK
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Credential |
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Telephone | 952-516-6800
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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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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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