1447522685 NPI number — PREFERRED TOUCH HOME CARE, 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 1447522685 NPI number — PREFERRED TOUCH HOME CARE, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PREFERRED TOUCH HOME CARE, 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:
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:
1447522685
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/26/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
510 VONDERBURG DR
Provider Second Line Business Mailing Address:
STE 308
Provider Business Mailing Address City Name:
BRANDON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33511-5954
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-702-1100
Provider Business Mailing Address Fax Number:
813-685-8973

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
510 VONDERBURG DRIVE
Provider Second Line Business Practice Location Address:
STE 308
Provider Business Practice Location Address City Name:
BRANDON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-702-1100
Provider Business Practice Location Address Fax Number:
813-685-8973
Provider Enumeration Date:
02/03/2012

Additional Information

Authorized Official

Authorized Official Last Name:
KATSNELSON
Authorized Official First Name:
GENNADY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
718-415-6167

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 103180 . This is a "MEDICARE PTAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 006118300 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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