Provider Demographics
NPI:1801931837
Name:PEOPLES HOME HEALTH LLC
Entity type:Organization
Organization Name:PEOPLES HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:ALFRED
Authorized Official - Last Name:BUTTELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-723-7076
Mailing Address - Street 1:213 E WRIGHT STREET
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-4917
Mailing Address - Country:US
Mailing Address - Phone:850-696-0911
Mailing Address - Fax:850-475-0690
Practice Address - Street 1:213 E WRIGHT STREET
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-4917
Practice Address - Country:US
Practice Address - Phone:850-696-0911
Practice Address - Fax:850-475-0690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299991537251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650889800Medicaid
FLY909SMedicare UPIN