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NPI Code Detail

MEDICARE: INTERIM HEALTHCARE OF NW FL INC

MEDICARE: INTERIM HEALTHCARE OF NW FL 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
1251E00000XHome Health AgencyFL

General Provider Information

NPI Number : 1811058266
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTERIM HEALTHCARE OF NW FL INC
Provider Business Mailing Address
First Line : 339 RACETRACK RD NW
Second Line : SUITE 16
City : FORT WALTON BEACH
State : FL
Zip : 32547-1538
Country : US
Telephone Number : 850-243-1152
Fax Number : 850-862-8548
Provider Business Practice Location Address
First Line : 339 RACETRACK RD NW
Second Line : SUITE 16
City : FORT WALTON BEACH
State : FL
Zip : 32547-1538
Country : US
Telephone Number : 850-243-1152
Fax Number : 850-862-8548
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. WILLIAM REAK
Credential : RN
Telephone Number : 850-243-1152
Provider Enumeration Date : 12/12/2006
Last Update Date : 08/22/2020

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Directions to “INTERIM HEALTHCARE OF NW FL INC ” Practice Location

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