Wilmas Companions Home Care

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

5897 Issued in FL

Legal business name

WILMAS COMPANIONS HOME CARE

Practice address

111 2ND Ave NE
330
St Petersburg, FL 33701-3434

Phone

(727) 209-2868

Fax

(727) 823-0796

NPI assigned

Oct 16, 2013

Organization subpart

No

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

Authorized official

Name

Frank Gilliam

Title

D.O.O.

Phone

(727) 209-2868

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• aunt wilmas companions home care Former legal business name

Locations

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381881600000",
    "number": "1588092258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 2ND AVE NE",
            "address_2": "330",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013434",
            "telephone_number": "727-209-2868",
            "fax_number": "727-823-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 2ND AVE NE",
            "address_2": "330",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013434",
            "telephone_number": "727-209-2868",
            "fax_number": "727-823-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILMAS COMPANIONS HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-10-16",
        "status": "A",
        "authorized_official_last_name": "GILLIAM",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "D.O.O.",
        "authorized_official_telephone_number": "727-209-2868"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "FL",
            "license": "5897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "680830100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "aunt wilmas companions home care",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.