MEDICARE: HILLSBOROUGH RIVER HEALTH CENTER INC

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	299993823	FL

General Provider Information

NPI Number	:	1124251350
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HILLSBOROUGH RIVER HEALTH CENTER INC

Provider Business Mailing Address
First Line	:	10612 CHAMBERS DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-2621
Country	:	US
Telephone Number	:	813-818-0744
Fax Number	:	813-555-5540

Provider Business Practice Location Address
First Line	:	2511 W SWANN AVE STE 205
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4048
Country	:	US
Telephone Number	:	888-517-4837
Fax Number	:	813-356-0376

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MR. AMBROSE IJEOMA UBACHUKWUEKE
Credential	:	RPH
Telephone Number	:	813-818-0744

Provider Enumeration Date	:	09/04/2009
Last Update Date	:	05/27/2011

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