Provider Demographics
NPI:1073747309
Name:AMEDIHEALTH HOME CARE SERVICES INC
Entity Type:Organization
Organization Name:AMEDIHEALTH HOME CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:V
Authorized Official - Last Name:REGIDOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-688-7241
Mailing Address - Street 1:1527 E MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33801-2222
Mailing Address - Country:US
Mailing Address - Phone:863-688-7241
Mailing Address - Fax:863-937-9319
Practice Address - Street 1:1527 E MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-2222
Practice Address - Country:US
Practice Address - Phone:863-688-1196
Practice Address - Fax:863-687-7707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-14
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health