Organization
CONRAD HEALTHCARE LLC
Active
Other names
Interim HealthCare of Charlotte County
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES CONRAD (PRESIDENT)
(239) 292-6754
Entity
Organization
Contact information
Practice address
3390 TAMIAMI TRL, SUITE 203, PORT CHARLOTTE, FL 33952-8157
(941) 787-5619
(941) 787-5618
Mailing address
3390 TAMIAMI TRL, SUITE 203, PORT CHARLOTTE, FL 33952-8157
(941) 787-5619
(941) 787-5618
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
299994379
HOME HEALTH AGENCY LICENSE
FL
Enumeration date
10/08/2014
Last updated
03/03/2015
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