Provider Demographics
NPI:1467697656
Name:EXCELL HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:EXCELL HOME HEALTH SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:P S VASANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-235-1722
Mailing Address - Street 1:22110 KIMBLE AVE
Mailing Address - Street 2:P.O.BOX 494530
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33949
Mailing Address - Country:US
Mailing Address - Phone:941-457-1142
Mailing Address - Fax:941-235-1524
Practice Address - Street 1:3911 GOLF PARK LOOP STE 101
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-3453
Practice Address - Country:US
Practice Address - Phone:941-457-1422
Practice Address - Fax:941-235-1524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL07000031587251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health