SHENANDOAH MEDICAL CARE CENTER NPI 1740608801

NPI Information

NPI: 1740608801
Provider Name: SHENANDOAH MEDICAL CARE CENTER
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 10D2121346

Address:
6313 LANSDOWNE CIR
BOYNTON BEACH, FL
ZIP 33472
Phone: (561) 853-7233
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SHENANDOAH MEDICAL CARE CENTER is a primary care clinic center in Boynton Beach, FL. SHENANDOAH MEDICAL CARE CENTER NPI is 1740608801. The provider is registered as an organization entity type.

The provider's business location address is:

6313 LANSDOWNE CIR
BOYNTON BEACH, FL
ZIP 33472-108
Phone: (561) 853-7233

The provider's authorized official is Joy L Fuller .
The authorized official title is Arnp and has the following contact phone number (561) 853-7233.

The CLIA number assigned to this NPI record is 10D2121346 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/4/2014 and was last updated on 4/4/2014.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	253Z00000X	In Home Supportive Care				No
2	261QP2300X	Clinic/Center	Primary Care	2602122	FLORIDA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1720228208	OTHER	FLORIDA	NPI
2	CE016Z	MEDICARE UPIN	FLORIDA

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

NPI Synchronization or Removal

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