Provider Demographics
NPI:1952316325
Name:FEDERAL HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:FEDERAL HEALTH CARE SERVICES, INC.
Other - Org Name:CAMELLIA HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILFORD
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:601-544-2903
Mailing Address - Street 1:PO BOX 1956
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39403-1956
Mailing Address - Country:US
Mailing Address - Phone:601-544-2903
Mailing Address - Fax:601-582-5241
Practice Address - Street 1:8890 W OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7235
Practice Address - Country:US
Practice Address - Phone:954-733-2220
Practice Address - Fax:954-733-2558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA20345096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
107229Medicare ID - Type UnspecifiedPROVIDER #