Provider Demographics
NPI:1780617704
Name:ADVENTHEALTH HOME HEALTH AND HOSPICE INC
Entity type:Organization
Organization Name:ADVENTHEALTH HOME HEALTH AND HOSPICE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-545-1409
Mailing Address - Street 1:13925 17TH ST
Mailing Address - Street 2:
Mailing Address - City:DADE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33525-4603
Mailing Address - Country:US
Mailing Address - Phone:813-779-6301
Mailing Address - Fax:813-779-6319
Practice Address - Street 1:13925 17TH ST
Practice Address - Street 2:
Practice Address - City:DADE CITY
Practice Address - State:FL
Practice Address - Zip Code:33525-4603
Practice Address - Country:US
Practice Address - Phone:813-779-6301
Practice Address - Fax:813-779-6319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251F00000X
FLHHA299992090251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108170OtherUNITED HEALTH MCR
FL108170OtherWELLCARE MCR
FL533OtherBLUE CROSS BLUE SHIELD
FL108170OtherUNIVERSAL HEALTHCARE MCR
FL108170OtherKEYSTONE HP WEST MCR
FL108170OtherHUMANA GOLD PLUS HMO MCR
FL108170OtherHUMANA GOLD CHC MCR
FL108170OtherWELLCARE MCR
FL108170Medicare Oscar/Certification