MEDICARE: PATIENT RESOURCES COMPANY, 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	261QD1600X	Developmental Disabilities Clinic/Center
2	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063058675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATIENT RESOURCES COMPANY, LLC

Provider Business Mailing Address
First Line	:	7520 NW 5TH ST STE 101
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33317-1613
Country	:	US
Telephone Number	:	954-999-0983
Fax Number	:	954-999-0113

Provider Business Practice Location Address
First Line	:	7520 NW 5TH ST STE 101
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33317-1613
Country	:	US
Telephone Number	:	954-999-0983
Fax Number	:	954-999-0113

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	COLLIN HALLER
Credential	:
Telephone Number	:	954-999-0983

Provider Enumeration Date	:	11/19/2019
Last Update Date	:	06/24/2026

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