Provider Demographics
NPI:1578032603
Name:PIVOTAL CARES, LLC
Entity Type:Organization
Organization Name:PIVOTAL CARES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAVON
Authorized Official - Middle Name:
Authorized Official - Last Name:WITTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-249-5381
Mailing Address - Street 1:2101 VISTA PARKWAY
Mailing Address - Street 2:SUITE 266
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411
Mailing Address - Country:US
Mailing Address - Phone:561-249-5381
Mailing Address - Fax:561-228-0771
Practice Address - Street 1:2101 VISTA PARKWAY
Practice Address - Street 2:SUITE 266
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411
Practice Address - Country:US
Practice Address - Phone:561-249-5381
Practice Address - Fax:561-228-0771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-19
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies