Provider Demographics
NPI:1861803850
Name:PINELLAS 1 HOME HEALTH CARE CORP
Entity type:Organization
Organization Name:PINELLAS 1 HOME HEALTH CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:HAEFELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-422-1675
Mailing Address - Street 1:4707 140TH AVENUE NORTH STE 106A
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762
Mailing Address - Country:US
Mailing Address - Phone:727-532-2111
Mailing Address - Fax:727-532-2333
Practice Address - Street 1:4707 140TH AVENUE NORTH STE 106A
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33762
Practice Address - Country:US
Practice Address - Phone:727-532-2111
Practice Address - Fax:727-532-2333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-13
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health