Provider Demographics
NPI:1427473552
Name:PASCO COUNTY BOARD OF COUNTY COMMISSIONERS
Entity type:Organization
Organization Name:PASCO COUNTY BOARD OF COUNTY COMMISSIONERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:MARIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-847-8949
Mailing Address - Street 1:37918 MERIDIAN AVE
Mailing Address - Street 2:
Mailing Address - City:DADE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33525-3822
Mailing Address - Country:US
Mailing Address - Phone:352-521-4111
Mailing Address - Fax:352-521-4105
Practice Address - Street 1:8600 GALEN WILSON BLVD
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-5973
Practice Address - Country:US
Practice Address - Phone:727-834-3340
Practice Address - Fax:727-834-3326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6711278Medicaid