Provider Demographics
NPI:1609007780
Name:AFTERHOURS HEALTHCARE INC
Entity Type:Organization
Organization Name:AFTERHOURS HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ARNP
Authorized Official - Prefix:MS
Authorized Official - First Name:JOELLA
Authorized Official - Middle Name:C
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:386-793-6628
Mailing Address - Street 1:159 CAULEY LN
Mailing Address - Street 2:
Mailing Address - City:BUNNELL
Mailing Address - State:FL
Mailing Address - Zip Code:32110-7915
Mailing Address - Country:US
Mailing Address - Phone:386-793-6628
Mailing Address - Fax:
Practice Address - Street 1:159 CAULEY LN
Practice Address - Street 2:
Practice Address - City:BUNNELL
Practice Address - State:FL
Practice Address - Zip Code:32110-7915
Practice Address - Country:US
Practice Address - Phone:386-793-6628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9216912261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care