Provider Demographics
NPI:1982687968
Name:FIRST HEALTH SYSTEMS
Entity Type:Organization
Organization Name:FIRST HEALTH SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GOLDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PROPHETE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-641-9440
Mailing Address - Street 1:7450 GRIFFIN RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-4104
Mailing Address - Country:US
Mailing Address - Phone:954-641-9440
Mailing Address - Fax:954-641-9448
Practice Address - Street 1:7450 GRIFFIN RD
Practice Address - Street 2:SUITE 240
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-4104
Practice Address - Country:US
Practice Address - Phone:954-641-9440
Practice Address - Fax:954-641-9448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-23
Last Update Date:2010-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA299991454251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107680Medicare ID - Type Unspecified