Provider Demographics
NPI:1174211585
Name:NURIZON AT HOME
Entity type:Organization
Organization Name:NURIZON AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SVAGDIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-856-2491
Mailing Address - Street 1:9160 FORUM CORPORATE PKWY STE 350
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-7808
Mailing Address - Country:US
Mailing Address - Phone:239-789-4732
Mailing Address - Fax:239-203-2243
Practice Address - Street 1:9160 FORUM CORPORATE PKWY STE 350
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-7808
Practice Address - Country:US
Practice Address - Phone:239-789-4732
Practice Address - Fax:239-203-2243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care