MEDICARE: MYCARE HOME HEALTH PALM BEACH, 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

General Provider Information

NPI Number	:	1437310398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MYCARE HOME HEALTH PALM BEACH, INC

Provider Business Mailing Address
First Line	:	1501 S PALMWAY
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33460-5765
Country	:	US
Telephone Number	:	561-818-3022
Fax Number	:	561-533-6630

Provider Business Practice Location Address
First Line	:	1501 S PALMWAY
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33460-5765
Country	:	US
Telephone Number	:	561-818-3022
Fax Number	:	561-533-6630

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GLENN PFAFF
Credential	:	RN
Telephone Number	:	561-818-3022

Provider Enumeration Date	:	06/23/2008
Last Update Date	:	06/23/2008

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