Provider Demographics
NPI:1558763961
Name:BLUESTONE HEALTHCARE, INC.
Entity Type:Organization
Organization Name:BLUESTONE HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGELO
Authorized Official - Middle Name:
Authorized Official - Last Name:TEAMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-972-9351
Mailing Address - Street 1:2101 VISTA PKWY
Mailing Address - Street 2:#205
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2706
Mailing Address - Country:US
Mailing Address - Phone:786-972-9351
Mailing Address - Fax:561-328-7832
Practice Address - Street 1:2101 VISTA PKWY
Practice Address - Street 2:#205
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-2706
Practice Address - Country:US
Practice Address - Phone:786-972-9351
Practice Address - Fax:561-328-7832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health