Provider Demographics
NPI:1295965341
Name:CORBETTS ELDERLY CARES U ANYWHERE
Entity type:Organization
Organization Name:CORBETTS ELDERLY CARES U ANYWHERE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRANSPORTATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERIKA
Authorized Official - Middle Name:S
Authorized Official - Last Name:CORBETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-345-3817
Mailing Address - Street 1:P.O. BOX 1036
Mailing Address - Street 2:
Mailing Address - City:WOODVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32362
Mailing Address - Country:US
Mailing Address - Phone:850-345-3817
Mailing Address - Fax:850-325-1429
Practice Address - Street 1:2906 PROSPECT ST.
Practice Address - Street 2:
Practice Address - City:TALLA
Practice Address - State:FL
Practice Address - Zip Code:32301
Practice Address - Country:US
Practice Address - Phone:850-345-3817
Practice Address - Fax:850-325-1429
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORBETTS ELDERLY CARES U ANYWHERE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO9000056589343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)