Provider Demographics
NPI:1083214258
Name:S & DS NEWHEALTH AGENCY LLC
Entity Type:Organization
Organization Name:S & DS NEWHEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SUZETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRENDERGAST
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:561-389-2721
Mailing Address - Street 1:2832 SHAUGHNESSY DR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6496
Mailing Address - Country:US
Mailing Address - Phone:561-389-2721
Mailing Address - Fax:
Practice Address - Street 1:2832 SHAUGHNESSY DR
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6496
Practice Address - Country:US
Practice Address - Phone:561-389-2721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health