Provider Demographics
NPI:1649499914
Name:JOHN KNOX HOME HEALTH AGENCY, INC
Entity type:Organization
Organization Name:JOHN KNOX HOME HEALTH AGENCY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:DU BOIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:954-783-4009
Mailing Address - Street 1:550 SW 3RD ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-6934
Mailing Address - Country:US
Mailing Address - Phone:954-783-4009
Mailing Address - Fax:954-783-4010
Practice Address - Street 1:550 SW 3RD ST
Practice Address - Street 2:SUITE 300
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-6934
Practice Address - Country:US
Practice Address - Phone:954-783-4009
Practice Address - Fax:954-783-4010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20601096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health