NPIMap

Organization Active NPI

Hollywood Healthcare Corp

  • Durable Medical Equipment & Medical Supplies
  • Davie, FL
National Provider Identifier
1124133798
Registry record updated Dec 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
PH16241 Issued in FL
Legal business name
HOLLYWOOD HEALTHCARE CORP
Practice address
15851 SW 41St St
Suite 700
Davie, FL 33331-1541
Phone
(954) 349-9551
Fax
(954) 349-9552
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2008

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

Authorized official

Name
Mr. Robert Kusher
Title
President
Phone
(954) 349-9551

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PH16241 FL Primary

Addresses

Primary practice location

15851 SW 41St St
Suite 700
Davie, FL 33331-1541

Mailing address

15851 SW 41St St
Suite 700
Davie, FL 33331-1541
Phone (954) 349-9551

Other identifiers 16

IdentifierTypeStateIssuer
2291970MedicaidOH
524128600MedicaidMN
5605529MedicaidMT
K2125MedicaidNM
100247010BMedicaidOK
100247010AMedicaidOK
54003371MedicaidKY
200357480AMedicaidIN
3388230MedicaidNV
806289500MedicaidID
636251MedicaidAZ
699759700MedicaidMD
4480718MedicaidMI
DME 100411330BMedicaidKS
00932654AMedicaidGA
8771511MedicaidNJ

Other names 1

  • Logimedix Doing business as

National Provider Directory

National Provider Directory

Locations

15851 SW 41st St
Ste 700
Davie, FL 33331
Phone (954) 349-9551

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229904000000",
    "number": "1124133798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15851 SW 41ST ST",
            "address_2": "SUITE 700",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333311541",
            "telephone_number": "954-349-9551",
            "fax_number": "954-349-9552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15851 SW 41ST ST",
            "address_2": "SUITE 700",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333311541",
            "telephone_number": "954-349-9551",
            "fax_number": "954-349-9552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLYWOOD HEALTHCARE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-12-22",
        "status": "A",
        "authorized_official_last_name": "KUSHER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-349-9551",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "PH16241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2291970",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "524128600",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5605529",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "K2125",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100247010B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100247010A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54003371",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200357480A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3388230",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806289500",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "636251",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "699759700",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4480718",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME 100411330B",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00932654A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8771511",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Logimedix",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2008; 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.