MEDICARE: DURHAM CARE SERVICES

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	343900000X	Non-emergency Medical Transport (VAN)
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1962287631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DURHAM CARE SERVICES

Provider Business Mailing Address
First Line	:	6404 FARMHILL CT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-7389
Country	:	US
Telephone Number	:	904-849-5380
Fax Number	:

Provider Business Practice Location Address
First Line	:	6404 FARMHILL CT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-7389
Country	:	US
Telephone Number	:	904-849-5380
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	RAELYN DURHAM
Credential	:	DBA
Telephone Number	:	904-849-5380

Provider Enumeration Date	:	08/30/2023
Last Update Date	:	08/30/2023

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