MEDICARE: EC OPCO CARROLLWOOD, 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	310400000X	Assisted Living Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861993206
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EC OPCO CARROLLWOOD, LLC

Provider Business Mailing Address
First Line	:	500 N HURSTBORNE PKWY
Second Line	:	SUITE 200
City	:	LOUISVILLE
State	:	KY
Zip	:	40222
Country	:	US
Telephone Number	:	971-213-4234
Fax Number	:

Provider Business Practice Location Address
First Line	:	2626 W. BEARSS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618
Country	:	US
Telephone Number	:	813-960-5346
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHRISTIAN N. CUMMINGS
Credential	:
Telephone Number	:	312-660-3800

Provider Enumeration Date	:	02/21/2018
Last Update Date	:	02/18/2026

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