1578704003 NPI number — HORIZON NURSING REGISTRY, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578704003 NPI number — HORIZON NURSING REGISTRY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HORIZON NURSING REGISTRY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HORIZON NURSING SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578704003
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4765 S CONGRESS AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALM SPRINGS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33461-4700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-432-1932
Provider Business Mailing Address Fax Number:
561-432-1492

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4765 S CONGRESS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALM SPRINGS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33461-4700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-432-1932
Provider Business Practice Location Address Fax Number:
561-432-1492
Provider Enumeration Date:
03/12/2009

Additional Information

Authorized Official

Authorized Official Last Name:
ROBINSON
Authorized Official First Name:
MARLENE
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
561-432-1932

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  30211109 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 023576200 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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