1396244646 NPI number — CORAL SPRINGS HYPERBERIC OXYGEN AND WOUND CARE CENTER LLC

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 1396244646 NPI number — CORAL SPRINGS HYPERBERIC OXYGEN AND WOUND CARE CENTER LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CORAL SPRINGS HYPERBERIC OXYGEN AND WOUND CARE CENTER LLC
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:
Provider Other Organization Name Type Code:
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:
1396244646
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/01/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8114
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORAL SPRINGS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33075-8114
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-440-6270
Provider Business Mailing Address Fax Number:
305-721-1525

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8333 W MCNAB
Provider Second Line Business Practice Location Address:
107
Provider Business Practice Location Address City Name:
TAMARAC
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-684-8335
Provider Business Practice Location Address Fax Number:
305-721-1525
Provider Enumeration Date:
02/01/2018

Additional Information

Authorized Official

Authorized Official Last Name:
TOWNSEL
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNSER
Authorized Official Telephone Number:
954-440-6270

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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