Provider Demographics
NPI:1568589372
Name:INTERIM HEALTHCARE PRIVATE SERVICES, INC.
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE PRIVATE SERVICES, INC.
Other - Org Name:INTERIM HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BIXBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-326-0400
Mailing Address - Street 1:32644 BLOSSOM LN
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34788-3928
Mailing Address - Country:US
Mailing Address - Phone:352-326-0400
Mailing Address - Fax:352-365-1521
Practice Address - Street 1:32644 BLOSSOM LN
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34788-3928
Practice Address - Country:US
Practice Address - Phone:352-326-0400
Practice Address - Fax:352-365-1521
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERIM HEALTHCARE PRIVATE SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-25
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20578096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health