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BEACHLAND RETIREMENT HOME NPI 1376981985


NPI Information

NPI: 1376981985
Provider Name: BEACHLAND RETIREMENT HOME
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
462 HERNANDO ST
FORT PIERCE, FL
ZIP 34949
Phone: (772) 460-8007
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BEACHLAND RETIREMENT HOME is a clinic center in Fort Pierce, FL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). BEACHLAND RETIREMENT HOME NPI is 1376981985. The provider is registered as an organization entity type.

The provider's business location address is:

462 HERNANDO ST
FORT PIERCE, FL
ZIP 34949-243
Phone: (772) 460-8007
Fax: (772) 460-8007

The provider's authorized official is Roman Grochowski .
The authorized official title is Administrator/owner and has the following contact phone number (772) 460-8007.

The enumeration date for this NPI number is 6/6/2013 and was last updated on 6/6/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/Center8841FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1675980700MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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