Provider Demographics
NPI:1023135837
Name:INTERIM HEALTHCARE PRIVATE SERVICES, INC.
Entity type:Organization
Organization Name:INTERIM HEALTHCARE PRIVATE SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:F
Authorized Official - Last Name:BIXBY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:352-326-3800
Mailing Address - Street 1:3760 NW 83RD ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-6020
Mailing Address - Country:US
Mailing Address - Phone:352-378-0333
Mailing Address - Fax:352-375-5890
Practice Address - Street 1:3760 NW 83RD ST
Practice Address - Street 2:SUITE 2
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-6020
Practice Address - Country:US
Practice Address - Phone:352-378-0333
Practice Address - Fax:352-375-5890
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERIM HEALTHCARE PRIVATE SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-25
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20572096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health