1467697656 NPI number — EXCELL HOME HEALTH SERVICES LLC

Table of content: (NPI 1467697656)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467697656 NPI number — EXCELL HOME HEALTH SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EXCELL HOME HEALTH 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:
SUNRISE HOME HEALTH & SPPLIES OF BRADENTON
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:
1467697656
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22110 KIMBLE AVE
Provider Second Line Business Mailing Address:
P.O.BOX 494530
Provider Business Mailing Address City Name:
PORT CHARLOTTE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33949
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
941-457-1142
Provider Business Mailing Address Fax Number:
941-235-1524

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3911 GOLF PARK LOOP STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRADENTON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34203-3453
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-457-1422
Provider Business Practice Location Address Fax Number:
941-235-1524
Provider Enumeration Date:
12/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
NAIR
Authorized Official First Name:
P S VASANTHA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
941-235-1722

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  L07000031587 , 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)





Copyright © 2007-2024 www.npivalidator.com