Provider Demographics
NPI:1578883021
Name:DELEMAR HOME CARE INC.
Entity Type:Organization
Organization Name:DELEMAR HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EARL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BLACKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:ATP
Authorized Official - Phone:804-986-8143
Mailing Address - Street 1:6801 LAKE WORTH RD
Mailing Address - Street 2:STE 101
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2955
Mailing Address - Country:US
Mailing Address - Phone:561-967-5932
Mailing Address - Fax:561-967-5934
Practice Address - Street 1:6801 LAKE WORTH RD
Practice Address - Street 2:STE 101
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33467-2955
Practice Address - Country:US
Practice Address - Phone:561-967-5932
Practice Address - Fax:561-967-5934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP09000039363251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherIRS