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
National Provider Directory
- Tax ID family
- Professional Home Health Care LLC
Locations
15207 Carrollton Blvd
Carrollton, VA 23314
Phone (757) 238-9888
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0172515899 | Medicaid | VA | |
| 0172516350 | Medicaid | VA |
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All providers in Carrollton, VA · Home Health Agency in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.