Cmojules LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CMOJULES LLC

Practice address

2331 Pembrook Dr
Clearwater, FL 33764-6548

Phone

(727) 536-5865

NPI assigned

Mar 4, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Collin B Mulder, R.N

Title

Administrator/Owner

Phone

(727) 536-5865

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pembrook Place Doing business as

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

{
    "created_epoch": "1362355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362355200000",
    "number": "1184965097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 PEMBROOK DR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337646548",
            "telephone_number": "727-536-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 PEMBROOK DR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337646548",
            "telephone_number": "727-536-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMOJULES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-04",
        "last_updated": "2013-03-04",
        "status": "A",
        "authorized_official_last_name": "MULDER",
        "authorized_official_first_name": "COLLIN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "727-536-5865",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.N"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003855600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pembrook Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; 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.