MEDICARE: HH STUART LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	20646095	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20646095	OTHER	FL	STATE LICENSE PERMIT

General Provider Information

NPI Number	:	1043338213
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HH STUART LLC

Provider Business Mailing Address
First Line	:	PO BOX 200
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30903-0200
Country	:	US
Telephone Number	:	706-303-5500
Fax Number	:	706-854-7382

Provider Business Practice Location Address
First Line	:	1903 S CONGRESS AVE
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-6548
Country	:	US
Telephone Number	:	561-806-7027
Fax Number	:	561-806-7032

Authorized Official
Title or Position	:	SR VP
Name	:	MR. WALTER WRIGHT
Credential	:
Telephone Number	:	706-854-7301

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	10/31/2023

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Directions to “HH STUART LLC ” Practice Location

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