1750330833 NPI number — YHMO, LLC

Table of content: (NPI 1750330833)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750330833 NPI number — YHMO, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YHMO, 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:
YOUR HOME MEDICAL
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:
1750330833
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1290 HAND AVE
Provider Second Line Business Mailing Address:
SUITES C & D
Provider Business Mailing Address City Name:
ORMOND BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32174-3112
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
386-677-6766
Provider Business Mailing Address Fax Number:
386-257-9332

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1290 HAND AVE
Provider Second Line Business Practice Location Address:
SUITES C & D
Provider Business Practice Location Address City Name:
ORMOND BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32174-3112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
386-677-6766
Provider Business Practice Location Address Fax Number:
386-257-9332
Provider Enumeration Date:
05/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LONG
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
Authorized Official Title or Position:
VP
Authorized Official Telephone Number:
386-698-3737

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X , with the licence number:  10890 , 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: R9869 . This is a "BCBSFL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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