MEDICARE: EXTREME QUALITY HOME HEALTH CARE CORP

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

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	:	1396023123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXTREME QUALITY HOME HEALTH CARE CORP

Provider Business Mailing Address
First Line	:	12995 S CLEVELAND AVE STE 232
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-3809
Country	:	US
Telephone Number	:	239-288-4951
Fax Number	:	239-288-4961

Provider Business Practice Location Address
First Line	:	12995 S CLEVELAND AVE STE 232
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-3809
Country	:	US
Telephone Number	:	239-288-4951
Fax Number	:	239-288-4961

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. HARI SHANTHAN NAGI REDDY
Credential	:
Telephone Number	:	317-652-1584

Provider Enumeration Date	:	07/27/2011
Last Update Date	:	09/06/2023

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