Provider Demographics
NPI:1609150846
Name:OPEN SYSTEMS HEALTHCARE, INC.
Entity Type:Organization
Organization Name:OPEN SYSTEMS HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CONTRACT DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-888-2844
Mailing Address - Street 1:3333 S CONGRESS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-7300
Mailing Address - Country:US
Mailing Address - Phone:561-274-4149
Mailing Address - Fax:561-450-1443
Practice Address - Street 1:1818 MARKET ST
Practice Address - Street 2:SUITE 2510
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-3638
Practice Address - Country:US
Practice Address - Phone:215-399-0598
Practice Address - Fax:215-567-2482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-06
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299994431251E00000X
251E00000X, 253Z00000X, 261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015611000Medicaid
DC027477421Medicaid
DC067990321Medicaid
FL299994431OtherAHCA LICENSE