Organization Active NPI

HCR Manor Care Services of Florida III, LLC

  • Community Based Hospice Care Agency
  • Plantation, FL
National Provider Identifier
1669768594
Registry record updated Jan 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
HCR MANOR CARE SERVICES OF FLORIDA III, LLC
Practice address
150 S Pine Island Rd Ste 540
Plantation, FL 33324-2667
Phone
(954) 467-7423
Fax
(954) 467-7087
NPI assigned
Jun 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2022

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

Authorized official

Name
Mr. Martin D Allen
Title
Director
Phone
(419) 252-5734

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X
Community Based Hospice Care Agency 251G00000X FL Primary

Addresses

Primary practice location

150 S Pine Island Rd Ste 540
Plantation, FL 33324-2667

Mailing address

150 S Pine Island Rd Ste 540
Plantation, FL 33324-2667
Phone (954) 467-7423

Other names 1

  • ProMedica Hospice (Broward) Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200807002050 FL Part B Supplier - Clinic/Group Practice 1951573153 Receives reassigned benefits from 2 practitioners
2 other NPIs on this enrollment
Practice locations: Hallandale Beach, FL; Plantation, FL; South Miami, FL

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

134 S Dixie Hwy
Hallandale Beach, FL 33009
Phone (754) 260-3426

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Nov 1, 2023 Change of OwnershipThis provider was the seller Heartland Hospice (Broward)CCN 101502, FL, NPI 1013617786

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642896000000",
    "number": "1669768594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S PINE ISLAND RD STE 540",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242667",
            "telephone_number": "954-467-7423",
            "fax_number": "954-467-7087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S PINE ISLAND RD STE 540",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242667",
            "telephone_number": "954-467-7423",
            "fax_number": "954-467-7087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HCR MANOR CARE SERVICES OF FLORIDA III, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-20",
        "last_updated": "2022-01-23",
        "certification_date": "2022-01-23",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Broward)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.