Provider Demographics
NPI:1720796279
Name:COLLIN BUCHANAN
Entity Type:Organization
Organization Name:COLLIN BUCHANAN
Other - Org Name:BETTER HOMES INN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:COLLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHANAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-523-5963
Mailing Address - Street 1:3715 E POWHATAN AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-3726
Mailing Address - Country:US
Mailing Address - Phone:813-523-5963
Mailing Address - Fax:
Practice Address - Street 1:3715 E POWHATAN AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-3726
Practice Address - Country:US
Practice Address - Phone:813-523-5963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home