Prince Charles Home Healthcare Agency, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PRINCE CHARLES HOME HEALTHCARE AGENCY, LLC

Practice address

110 Exchange St Ste F
Danville, VA 24541

Phone

(434) 835-0124

Fax

(434) 835-0171

NPI assigned

Aug 1, 2014

Organization subpart

No

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

Authorized official

Name

Tashunna Haley Bauldwin

Title

Administrator

Phone

(434) 835-0124

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1406851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528761600000",
    "number": "1144638222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 EXCHANGE ST STE F",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245413500",
            "telephone_number": "434-835-0171",
            "fax_number": "434-835-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 EXCHANGE ST STE F",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "24541",
            "telephone_number": "434-835-0124",
            "fax_number": "434-835-0171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5656 U S Highway 29",
            "address_2": "Unit B1",
            "address_purpose": "LOCATION",
            "city": "Blairs",
            "state": "VA",
            "postal_code": "245272411",
            "country_code": "US",
            "telephone_number": "336-254-2991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRINCE CHARLES HOME HEALTHCARE AGENCY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-01",
        "last_updated": "2018-06-12",
        "status": "A",
        "authorized_official_last_name": "BAULDWIN",
        "authorized_official_first_name": "TASHUNNA",
        "authorized_official_middle_name": "HALEY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "434-835-0124"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.