Professional Home Health Care LLC

Organization Active NPI Home Health Agency · Carrollton, VA

NPI 1609259787 · NPPES record last updated Jul 7, 2015

Key facts

NPI
1609259787
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
License
HOC-151063 (VA)
Legal business name
PROFESSIONAL HOME HEALTH CARE LLC
Practice address
15207 Carrollton Blvd
Carrollton, VA 23314-2303
Phone
(757) 238-9888
NPI assigned
Jul 7, 2015
Organization subpart
No

Authorized official

Name
Semeiko Gambrell
Title
Administrator
Phone
(757) 238-9888

Corporate family (same tax ID) 1

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

National Provider Directory

Tax ID family
Professional Home Health Care LLC (2 organizations share this tax ID)

Locations

15207 Carrollton Blvd
Carrollton, VA 23314
Phone (757) 238-9888

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HOC-151063 VA Yes

Addresses

Primary practice location

15207 Carrollton Blvd
Carrollton, VA 23314-2303

Mailing address

15207 Carrollton Blvd
Carrollton, VA 23314-2303
Phone (757) 238-9888

Other identifiers

IdentifierTypeStateIssuer
0172515899MedicaidVA
0172516350MedicaidVA

Other providers in Carrollton, VA

All providers in Carrollton, VA · Home Health Agency in Virginia

Sources for this page

Verify at the official NPI Registry.