1427200096 NPI number — HCP SERVICES, LLC

Table of content: (NPI 1427200096)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427200096 NPI number — HCP SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HCP SERVICES, 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:
HCP HOME HEALTH AGENCY
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:
1427200096
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
901 NW 8TH AVE
Provider Second Line Business Mailing Address:
SUITE B-6
Provider Business Mailing Address City Name:
GAINESVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32601-5011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-284-2336
Provider Business Mailing Address Fax Number:
352-373-2254

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
901 NW 8TH AVE
Provider Second Line Business Practice Location Address:
B-6
Provider Business Practice Location Address City Name:
GAINESVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32601-5011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-284-2336
Provider Business Practice Location Address Fax Number:
352-373-2254
Provider Enumeration Date:
10/15/2008

Additional Information

Authorized Official

Authorized Official Last Name:
TUMA
Authorized Official First Name:
JON
Authorized Official Middle Name:
A
Authorized Official Title or Position:
MANGING DIRECTOR
Authorized Official Telephone Number:
352-284-2336

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  299993819 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 253Z00000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 002132000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 003795600 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 689845996 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 003795600 . 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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