Emerald Coast Lifecare, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

39967218 Issued in FL

Legal business name

EMERALD COAST LIFECARE, INC.

Practice address

815 Bayshore Dr
Suite a
Niceville, FL 32578-2548

Phone

(850) 659-3125

Fax

(850) 659-3123

NPI assigned

Aug 23, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Stephen W Ruckel

Title

President

Phone

(850) 659-3125

Specialties & licenses 1

Addresses

Other names 1

• Brightstar Emerald Coast Doing business as

Locations

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

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314057600000",
    "number": "1942580873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 BAYSHORE DR",
            "address_2": "SUITE A",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325782548",
            "telephone_number": "850-659-3125",
            "fax_number": "850-659-3123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 BAYSHORE DR",
            "address_2": "SUITE A",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325782548",
            "telephone_number": "850-659-3125",
            "fax_number": "850-659-3123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD COAST LIFECARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-23",
        "last_updated": "2011-08-23",
        "status": "A",
        "authorized_official_last_name": "RUCKEL",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-659-3125",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "39967218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brightstar Emerald Coast",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Niceville, FL
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; 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.