Provider Demographics
NPI:1841257656
Name:PADGETTS HOME CARE & OSTOMY CENTER INC
Entity type:Organization
Organization Name:PADGETTS HOME CARE & OSTOMY CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT SEC TREAS
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:BUTLER
Authorized Official - Last Name:PADGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-892-3037
Mailing Address - Street 1:4050 13TH STREET
Mailing Address - Street 2:
Mailing Address - City:ST CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769
Mailing Address - Country:US
Mailing Address - Phone:407-892-3037
Mailing Address - Fax:407-892-5572
Practice Address - Street 1:4050 13TH STREET
Practice Address - Street 2:
Practice Address - City:ST CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769
Practice Address - Country:US
Practice Address - Phone:407-892-3037
Practice Address - Fax:407-892-5572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL105332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL027651100Medicaid
FL027651100Medicaid