Provider Demographics
NPI:1477274199
Name:NEAT COMPANION CARE
Entity Type:Organization
Organization Name:NEAT COMPANION CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TIFFANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-656-7138
Mailing Address - Street 1:PO BOX 444
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34785-0444
Mailing Address - Country:US
Mailing Address - Phone:727-656-7138
Mailing Address - Fax:
Practice Address - Street 1:121 N FLORIDA AVE
Practice Address - Street 2:STE D
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34453-1621
Practice Address - Country:US
Practice Address - Phone:727-656-7138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory