1215687157 NPI number — ROSEMARIES SUPPORT SERVICES 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 1215687157 NPI number — ROSEMARIES SUPPORT SERVICES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROSEMARIES SUPPORT 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:
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:
1215687157
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16841 67TH CT N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOXAHATCHEE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33470-3332
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-294-3820
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16841 67TH CT N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOXAHATCHEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33470-3332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-294-3820
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/24/2022

Additional Information

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
ROSEMARIE
Authorized Official Middle Name:
S
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
561-294-3820

Provider Taxonomy Codes

  • Taxonomy code: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 687535196 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com