Provider Demographics
NPI:1437180239
Name:PROJECT HEALTH INC
Entity type:Organization
Organization Name:PROJECT HEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHASE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-793-5900
Mailing Address - Street 1:1425 S US 301
Mailing Address - Street 2:
Mailing Address - City:SUMTERVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:33585-5141
Mailing Address - Country:US
Mailing Address - Phone:352-793-5900
Mailing Address - Fax:352-793-8050
Practice Address - Street 1:1389 S US 301
Practice Address - Street 2:
Practice Address - City:SUMTERVILLE
Practice Address - State:FL
Practice Address - Zip Code:33585-5143
Practice Address - Country:US
Practice Address - Phone:352-793-5900
Practice Address - Fax:352-793-9558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLN/A261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL99022OtherBLUE CROSS BLUE SHIELD
FL029547700Medicaid
FL10D0289672OtherCLIA
FL609521400OtherDEPT OF LABOR
FL029547700Medicaid
FL4133860001OtherDME
FL609521400OtherDEPT OF LABOR
FL029547700Medicaid
FL4133860001OtherDME
FL609521400OtherDEPT OF LABOR