Provider Demographics
NPI:1427276153
Name:ATKINSON'S HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:ATKINSON'S HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MUYRES
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT/CEO
Authorized Official - Phone:904-269-8050
Mailing Address - Street 1:4110 SOUTHPOINT BLVD.
Mailing Address - Street 2:STE. 110
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216
Mailing Address - Country:US
Mailing Address - Phone:904-269-8050
Mailing Address - Fax:904-269-7378
Practice Address - Street 1:4110 SOUTHPOINT BLVD.
Practice Address - Street 2:STE. 110
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216
Practice Address - Country:US
Practice Address - Phone:904-269-8050
Practice Address - Fax:904-269-7378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL201550952251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL027005900Medicaid
FL163507OtherHEALTHEASE
FL080452596Medicaid
FLR3463OtherBCBS DME
FLJ3MOtherBCBS HOME HEALTH
FL027005901Medicaid
FL027005901Medicaid
FL080452596Medicaid