Provider Demographics
NPI:1164480190
Name:MEGA NURSING SERVICES INC
Entity Type:Organization
Organization Name:MEGA NURSING SERVICES INC
Other - Org Name:MEGA MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:LYCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-840-6566
Mailing Address - Street 1:4910 DYER BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-1009
Mailing Address - Country:US
Mailing Address - Phone:561-840-6566
Mailing Address - Fax:561-840-7620
Practice Address - Street 1:4910 DYER BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-1009
Practice Address - Country:US
Practice Address - Phone:561-840-6566
Practice Address - Fax:561-840-7620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20710095251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL670696706Medicaid
FL670696768OtherMEDICAID WAIVER CDC PLUS
FL670696716OtherMEDICAID WAIVER
FL670696796Medicaid
FL670696707Medicaid
FL670696707Medicaid