Provider Demographics
NPI:1922067230
Name:SUN COAST HOME CARE SERVICES, INC.
Entity Type:Organization
Organization Name:SUN COAST HOME CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JULITA
Authorized Official - Middle Name:E
Authorized Official - Last Name:LATHERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:941-625-1530
Mailing Address - Street 1:3508 TAMIAMI TRL
Mailing Address - Street 2:SUITE A
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-8160
Mailing Address - Country:US
Mailing Address - Phone:941-629-1600
Mailing Address - Fax:941-629-1606
Practice Address - Street 1:3508 TAMIAMI TRL
Practice Address - Street 2:SUITE A
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8160
Practice Address - Country:US
Practice Address - Phone:941-629-1600
Practice Address - Fax:941-629-1606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLWAITING FOR ISSUANCEMedicare ID - Type UnspecifiedPASSED STATE INSPECTION