MEDICARE: JOHN KNOX HOME HEALTH AGENCY, 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	20601096	FL

General Provider Information

NPI Number	:	1649499914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN KNOX HOME HEALTH AGENCY, INC

Provider Business Mailing Address
First Line	:	550 SW 3RD ST
Second Line	:	SUITE 300
City	:	POMPANO BEACH
State	:	FL
Zip	:	33060-6934
Country	:	US
Telephone Number	:	954-783-4009
Fax Number	:	954-783-4010

Provider Business Practice Location Address
First Line	:	550 SW 3RD ST
Second Line	:	SUITE 300
City	:	POMPANO BEACH
State	:	FL
Zip	:	33060-6934
Country	:	US
Telephone Number	:	954-783-4009
Fax Number	:	954-783-4010

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. BARBARA DU BOIS
Credential	:	RN
Telephone Number	:	954-783-4009

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	08/22/2020

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