NPIMap

Organization Active NPI

S & S Health Care, Inc.

Doing business as Interim HealthCare

  • Home Health Agency
  • Christiansburg, VA
National Provider Identifier
1124078886
Registry record updated Sep 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
S & S HEALTH CARE, INC.
Doing business as
Interim HealthCare
Practice address
201 Wheatland CT
Christiansburg, VA 24073-1091
Phone
(540) 381-2757
Fax
(540) 381-2769
NPI assigned
May 11, 2006
Last updated
Sep 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2010

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

Authorized official

Name
Mitchell P Davis
Title
Ceo/Owner
Phone
(540) 774-8686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

201 Wheatland CT
Christiansburg, VA 24073-1091

Mailing address

4395 Electric Road
Roanoke, VA 24018-0721
Phone (540) 774-8686

Other identifiers 4

IdentifierTypeStateIssuer
112237OtherVAANTHEM
008702683MedicaidVA
008770794MedicaidVA
008750785MedicaidVA

Other names 1

  • Interim HealthCare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030303000021 VA Part A Provider - Home Health Agency 0143139543 Practice locations: Christiansburg, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124078886. Details of each certification follow.

Home health agency certification: CCN 497573

Legal name
S & S HEALTH CARE, INC
Doing business as
INTERIM HEALTH CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 21, 2002
Last certification
Aug 24, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
May 22, 1989 in VA
Enrollment address
100 Arbor Dr
Ste 108
Christiansburg, VA 24073-6585

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Interim Healthcare - ChristiansburgCCN 497573 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Feb 21, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
S S Health Care Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

100 Arbor Dr
Ste 103
Christiansburg, VA 24073
Phone (540) 443-3428

201 Wheatland Ct
Christiansburg, VA 24073
Phone (540) 381-2757

20566 Timberlake Rd
Ste C
Lynchburg, VA 24502
Phone (434) 832-7460

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Tonya Harris Individual Corporate OfficerRegistered Agent/Board Member Jan 1, 2024
Corporate DirectorBroad Member/ Vice President Jan 1, 2024
W-2 Managing EmployeeVP of Operations Dec 1, 2016
Brian Runk Individual 5% Or Greater Direct Ownership Interest Aug 1, 2022 5%
Donna Byrd Individual 5% Or Greater Indirect Ownership InterestPresident/Board Member Jan 1, 2024 90%
Corporate OfficerCeo Jan 1, 2024
Corporate DirectorPresident Jan 1, 2024
Vickie Runk Individual 5% Or Greater Direct Ownership Interest Aug 1, 2022 5%
Kace Enterprises, Inc Organization, Salem, VA Corporation, For-profit 5% Or Greater Direct Ownership Interest Aug 1, 2022 90%

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285718400000",
    "number": "1124078886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4395 ELECTRIC ROAD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240180721",
            "telephone_number": "540-774-8686",
            "fax_number": "540-774-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 WHEATLAND CT",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240731091",
            "telephone_number": "540-381-2757",
            "fax_number": "540-381-2769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S & S HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2010-09-29",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "540-774-8686"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "112237",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008702683",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008770794",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008750785",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Interim HealthCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Christiansburg, VA

Sources for this page

Verify at the official NPI Registry.