MEDICARE: INTER-COASTAL HOME HEALTH CARE, 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	HHA299993101	FL

General Provider Information

NPI Number	:	1134450281
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTER-COASTAL HOME HEALTH CARE, INC

Provider Business Mailing Address
First Line	:	201 SE 15TH TER STE 202
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-4464
Country	:	US
Telephone Number	:	954-531-6190
Fax Number	:	561-300-3488

Provider Business Practice Location Address
First Line	:	201 SE 15TH TER STE 202
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-4464
Country	:	US
Telephone Number	:	954-531-6190
Fax Number	:	561-300-3488

Authorized Official
Title or Position	:	ALTERNATE ADMINISTRATOR
Name	:	MR. AMOS ARGENTINI
Credential	:
Telephone Number	:	954-531-6190

Provider Enumeration Date	:	01/28/2010
Last Update Date	:	01/28/2010

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