Provider Demographics
NPI:1477255453
Name:BRANJREWC, LLC
Entity Type:Organization
Organization Name:BRANJREWC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HYLTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-413-1991
Mailing Address - Street 1:10130 NORTHLAKE BLVD STE 214-108
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33412-1101
Mailing Address - Country:US
Mailing Address - Phone:908-413-1991
Mailing Address - Fax:
Practice Address - Street 1:9389 OSPREY ISLES BLVD
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33412-1118
Practice Address - Country:US
Practice Address - Phone:908-413-1991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care