MEDICARE: IN LOVING HANDS COMPASSIONATE FAMILY HOME CARE

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	:	1528525466
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IN LOVING HANDS COMPASSIONATE FAMILY HOME CARE

Provider Business Mailing Address
First Line	:	PO BOX 441435
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32222-0014
Country	:	US
Telephone Number	:	904-584-5724
Fax Number	:

Provider Business Practice Location Address
First Line	:	2044 DEAN A AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32208-3711
Country	:	US
Telephone Number	:	904-374-0217
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	VIRANDA D WHITE-TINSLEY
Credential	:
Telephone Number	:	904-584-5724

Provider Enumeration Date	:	02/27/2019
Last Update Date	:	02/27/2019

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