Express Pensacola HHA, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

299994035 Issued in FL

Legal business name

EXPRESS PENSACOLA HHA, INC.

Doing business as

Champion Home Health Care

Practice address

910 Airport Rd
Suite A1
Destin, FL 32541-2805

Phone

(850) 460-2108

Fax

(850) 460-2106

NPI assigned

Sep 12, 2012

Last updated

Sep 12, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Anthony A Kalishman

Title

VP

Phone

(352) 328-1607

Specialties & licenses 1

Addresses

Other names 1

• Champion Home Health Care Doing business as

Locations

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347408000000",
    "number": "1376893891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 AIRPORT RD",
            "address_2": "SUITE A1",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325412805",
            "telephone_number": "850-460-2108",
            "fax_number": "850-460-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 AIRPORT RD",
            "address_2": "SUITE A1",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325412805",
            "telephone_number": "850-460-2108",
            "fax_number": "850-460-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS PENSACOLA HHA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-12",
        "last_updated": "2012-09-12",
        "status": "A",
        "authorized_official_last_name": "KALISHMAN",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "352-328-1607",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299994035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Champion Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Destin, FL
• Providers in Destin, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.