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NPI Code Detail

MEDICARE: HARBORSIDE REHABILITATION LP

MEDICARE: HARBORSIDE REHABILITATION LP
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
1251J00000XNursing Care AgencyTZ9GMA
2251J00000XNursing Care AgencyNPA00019RI
3251J00000XNursing Care Agency611FL

General Provider Information

NPI Number : 1114048675
Entity Type Code : Organization
Provider Name (Legal Business Name) : HARBORSIDE REHABILITATION LP
Provider Business Mailing Address
First Line : 2602 HIGHLANDS BLVD N
Second Line :
City : PALM HARBOR
State : FL
Zip : 34684-2114
Country : US
Telephone Number : 800-276-4556
Fax Number : 727-786-6265
Provider Business Practice Location Address
First Line : 2602 HIGHLANDS BLVD N
Second Line :
City : PALM HARBOR
State : FL
Zip : 34684-2114
Country : US
Telephone Number : 800-276-4556
Fax Number : 727-786-6265
Authorized Official
Title or Position : PRESIDENT
Name : MR. JAMES EDWARD COCKE
Credential :
Telephone Number : 800-276-4556
Provider Enumeration Date : 04/03/2007
Last Update Date : 03/19/2008

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