Provider Demographics
NPI:1225207814
Name:EMERALD COAST SERVICES
Entity Type:Organization
Organization Name:EMERALD COAST SERVICES
Other - Org Name:COMFORT KEEPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/GM
Authorized Official - Prefix:MR
Authorized Official - First Name:K. TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:SWAIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-279-6310
Mailing Address - Street 1:742B GOVERNMENT AVE
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-1819
Mailing Address - Country:US
Mailing Address - Phone:850-279-6310
Mailing Address - Fax:866-869-0418
Practice Address - Street 1:742B GOVERNMENT AVE
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-1819
Practice Address - Country:US
Practice Address - Phone:850-279-6310
Practice Address - Fax:866-869-0418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health