Provider Demographics
NPI:1982750444
Name:OCALA GERIATRIC SERVICES INC
Entity Type:Organization
Organization Name:OCALA GERIATRIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-625-7777
Mailing Address - Street 1:1300 SW 42ND ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-1366
Mailing Address - Country:US
Mailing Address - Phone:352-207-9505
Mailing Address - Fax:352-873-8233
Practice Address - Street 1:1300 SW 42ND ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-1366
Practice Address - Country:US
Practice Address - Phone:352-207-9505
Practice Address - Fax:352-873-8233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK0676Medicare PIN