1073595336 NPI number — ACCOMPLISHED HOME CARE OF OCALA

Table of content: (NPI 1073595336)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073595336 NPI number — ACCOMPLISHED HOME CARE OF OCALA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACCOMPLISHED HOME CARE OF OCALA
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:
6
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:
1073595336
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/28/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1701 NE 42ND AVE STE 401
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OCALA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34470-8024
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-291-6611
Provider Business Mailing Address Fax Number:
352-291-0550

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1701 NE 42ND AVE STE 401
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OCALA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34470-8024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-291-6611
Provider Business Practice Location Address Fax Number:
352-291-0550
Provider Enumeration Date:
11/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
YURASKO
Authorized Official First Name:
ANDREW
Authorized Official Middle Name:
B
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
352-291-6611

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HHA299991904 , 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 © 2007-2025 www.npivalidator.com