1912025131 NPI number — INTERIM HEALTHCARE PRIVATE SERVICES, INC.

Table of content: (NPI 1912025131)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912025131 NPI number — INTERIM HEALTHCARE PRIVATE SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INTERIM HEALTHCARE PRIVATE SERVICES, 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:
INTERIM HEALTHCARE
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:
1912025131
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2010 NE 14TH STREET
Provider Second Line Business Mailing Address:
BUILDING 100
Provider Business Mailing Address City Name:
OCALA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34471
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-351-5040
Provider Business Mailing Address Fax Number:
352-351-5140

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2010 NE 14TH ST
Provider Second Line Business Practice Location Address:
BUILDING 100
Provider Business Practice Location Address City Name:
OCALA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34470-7740
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-351-5040
Provider Business Practice Location Address Fax Number:
352-351-5140
Provider Enumeration Date:
03/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BIXBY
Authorized Official First Name:
EDWARD
Authorized Official Middle Name:
F.
Authorized Official Title or Position:
OWNER PRESIDENT
Authorized Official Telephone Number:
352-326-3800

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  20576096 , 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)





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