Organization
PRIMARY CARE IN YOUR HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN CROKER ARNP (OWNER/MANAGER)
(386) 316-5439
Entity
Organization
Contact information
Practice address
341 W MINNESOTA AVE, ORANGE CITY, FL 32763-2205
(386) 316-5439
Mailing address
341 W MINNESOTA AVE, ORANGE CITY, FL 32763-2205
(386) 316-5439
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
ARNP3333802
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305918900
—
FL
Enumeration date
09/30/2012
Last updated
10/05/2012
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