Provider Demographics
NPI:1316167224
Name:EMPIRE HOME HEALTH AGENCY, INC
Entity type:Organization
Organization Name:EMPIRE HOME HEALTH AGENCY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.O.N.
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROJAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-869-2980
Mailing Address - Street 1:6555 NW 36 ST
Mailing Address - Street 2:SUITE 118
Mailing Address - City:VIRGINIA GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6900
Mailing Address - Country:US
Mailing Address - Phone:305-869-2980
Mailing Address - Fax:305-869-2983
Practice Address - Street 1:6555 NW 36 ST
Practice Address - Street 2:SUITE 118
Practice Address - City:VIRGINIA GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33166-6900
Practice Address - Country:US
Practice Address - Phone:305-869-2980
Practice Address - Fax:305-869-2983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299991740251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109038OtherHOME HEALTH AGENCY
FL109038OtherHOME HEALTH AGENCY