Ayadaway Health Services LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

L10000091096 Issued in FL

Legal business name

AYADAWAY HEALTH SERVICES LLC

Practice address

12225 Heron Cove CT
Jacksonville, FL 32218-8095

Phone

(904) 329-1990

Fax

(904) 329-1990

NPI assigned

Sep 16, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Elton Mitchell Halls, R.R.T.

Title

Registered Respiratory Therapist

Phone

(904) 329-1990

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284595200000",
    "number": "1093023608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12225 HERON COVE CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322188095",
            "telephone_number": "904-329-1990",
            "fax_number": "904-329-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12225 HERON COVE CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322188095",
            "telephone_number": "904-329-1990",
            "fax_number": "904-329-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AYADAWAY HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-16",
        "last_updated": "2010-09-16",
        "status": "A",
        "authorized_official_last_name": "HALLS",
        "authorized_official_first_name": "ELTON",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "REGISTERED RESPIRATORY THERAPIST",
        "authorized_official_telephone_number": "904-329-1990",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.R.T."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "L10000091096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.