MEDICARE: ARMSTRONG EXCLUSIVE CARE 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

General Provider Information

NPI Number	:	1316667264
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARMSTRONG EXCLUSIVE CARE LLC

Provider Business Mailing Address
First Line	:	1457 SW VICUNA LN
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34953-2254
Country	:	US
Telephone Number	:	772-333-4606
Fax Number	:

Provider Business Practice Location Address
First Line	:	732 NE JENSEN BEACH BLVD FL 34957
Second Line	:
City	:	JENSEN BEACH
State	:	FL
Zip	:	34957-4754
Country	:	US
Telephone Number	:	772-333-4606
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHONTAE ARMSTRONG
Credential	:	BA
Telephone Number	:	772-333-4606

Provider Enumeration Date	:	08/31/2022
Last Update Date	:	08/31/2022

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