MEDICARE: SARAH'S HOMECARE AGENCY 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		FL

General Provider Information

NPI Number	:	1629594213
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARAH'S HOMECARE AGENCY LLC

Provider Business Mailing Address
First Line	:	17017 W DIXIE HWY # 111
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-3764
Country	:	US
Telephone Number	:	786-565-8498
Fax Number	:	646-517-8402

Provider Business Practice Location Address
First Line	:	17017 W DIXIE HWY # 111
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-3764
Country	:	US
Telephone Number	:	786-565-8498
Fax Number	:	646-517-8402

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JACK HEINEY
Credential	:
Telephone Number	:	786-246-1159

Provider Enumeration Date	:	08/16/2017
Last Update Date	:	07/21/2022

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