1497058218 NPI number — AWESOME HANDS HEALTH SERVICES, LLC

Table of content: (NPI 1497058218)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497058218 NPI number — AWESOME HANDS HEALTH SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AWESOME HANDS HEALTH SERVICES, 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:
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:
1497058218
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/20/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
703 60TH STREET CT E STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRADENTON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34208-6266
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
941-747-0999
Provider Business Mailing Address Fax Number:
941-747-7839

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
703 60TH STREET CT E STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRADENTON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34208-6266
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-747-0999
Provider Business Practice Location Address Fax Number:
941-747-7839
Provider Enumeration Date:
12/16/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BOYERS
Authorized Official First Name:
TINA
Authorized Official Middle Name:
CAROL
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
941-747-0999

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  299994074 , 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: 299994074 . This is a "HOME HEALTH AGENCY" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com