1396931382 NPI number — ACE HOMECARE LLC

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 1396931382 NPI number — ACE HOMECARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACE HOMECARE 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:
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:
1396931382
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2261
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANGO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33550-2261
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-621-0020
Provider Business Mailing Address Fax Number:
813-621-0022

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5268 SUMMERLIN COMMONS WAY
Provider Second Line Business Practice Location Address:
UNIT 504
Provider Business Practice Location Address City Name:
FORT MYERS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33907-2155
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-936-3196
Provider Business Practice Location Address Fax Number:
239-936-7881
Provider Enumeration Date:
09/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BARLAAN
Authorized Official First Name:
ARTHUR
Authorized Official Middle Name:
SANGALANG
Authorized Official Title or Position:
CIO
Authorized Official Telephone Number:
813-621-0020

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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