Provider Demographics
NPI:1750445722
Name:CONVACARE SERVICES INC.
Entity Type:Organization
Organization Name:CONVACARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-530-7700
Mailing Address - Street 1:19387 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-3102
Mailing Address - Country:US
Mailing Address - Phone:727-431-8110
Mailing Address - Fax:877-524-9504
Practice Address - Street 1:2599 W FOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-2782
Practice Address - Country:US
Practice Address - Phone:812-323-2170
Practice Address - Fax:812-323-2627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2005118Medicaid
IN100279050AMedicaid
GA000849153AMedicaid
AL009942006Medicaid
TN4582408Medicaid
KY90032343Medicaid
TN4582408Medicaid
TN4582408Medicaid