Provider Demographics
NPI:1316045289
Name:NURSECORE MANAGEMENT SERVICES, LLC
Entity Type:Organization
Organization Name:NURSECORE MANAGEMENT SERVICES, LLC
Other - Org Name:NURSECORE OF OCALA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LOLLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-649-1166
Mailing Address - Street 1:PO BOX 201925
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-1925
Mailing Address - Country:US
Mailing Address - Phone:817-649-1166
Mailing Address - Fax:817-649-2638
Practice Address - Street 1:500 SW 10TH ST
Practice Address - Street 2:SUITE 311
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-2615
Practice Address - Country:US
Practice Address - Phone:352-351-4410
Practice Address - Fax:352-351-4389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207850962251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650892800Medicaid
FLH0ZOtherBLUE CROSS BLUE SHIELD
FL3828630679Medicaid
FL682452800Medicaid
FLH0ZOtherBLUE CROSS BLUE SHIELD