Provider Demographics
NPI:1740333244
Name:JOSEPH L MORSE HEALTH CENTER, INC.
Entity type:Organization
Organization Name:JOSEPH L MORSE HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-687-5753
Mailing Address - Street 1:4847 DAVID S MACK DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-8023
Mailing Address - Country:US
Mailing Address - Phone:561-471-5111
Mailing Address - Fax:561-683-4556
Practice Address - Street 1:4847 DAVID S MACK DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-8023
Practice Address - Country:US
Practice Address - Phone:561-471-5111
Practice Address - Fax:561-683-4556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5801Medicare ID - Type UnspecifiedMEDICARE GROUP PROVIDER