Organization
BIDWELL HOME CARE SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA BETH GILLIAN (ADMINISTRATOR)
(941) 505-0450
Entity
Organization
Contact information
Practice address
520 E OLYMPIA AVE, PUNTA GORDA, FL 33950-3838
(941) 505-0450
Mailing address
520 E OLYMPIA AVE, PUNTA GORDA, FL 33950-3838
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
299994400
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
299994400
AHCA
FL
Enumeration date
05/25/2016
Last updated
05/25/2016
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