Community Home Care, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0206009050 Issued in VA

Legal business name

COMMUNITY HOME CARE, INC.

Practice address

1490 Park Ave NW Ste 6
Norton, VA 24273-1631

Phone

(276) 439-1460

Fax

(276) 439-1461

NPI assigned

Jun 6, 2006

Last updated

Sep 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mary Lynn Krutak

Title

Evp/Cfo

Phone

(423) 302-3423

Specialties & licenses 2

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Mountain States Health Alliance

  dba Sycamore Shoals Hospital Psychiatric Unit

  • Psychiatric Hospital Unit
  • Elizabethton, TN
  • NPI 1710099742

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600732800000",
    "number": "1700825668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 PRINCETON RD STE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012026",
            "telephone_number": "276-439-1460",
            "fax_number": "276-439-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 PARK AVE NW STE 6",
            "city": "NORTON",
            "state": "VA",
            "postal_code": "242731631",
            "telephone_number": "276-439-1460",
            "fax_number": "276-439-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A",
        "authorized_official_last_name": "KRUTAK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "EVP/CFO",
        "authorized_official_telephone_number": "423-302-3423",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "VA",
            "license": "0206009050",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009135022",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica Leann Clisso, DDS
• Kelly Holdway Coches, DO
• Amalia Christeen Collins, MSW/ LCSW
• Chasity Collins, FNP
• Lindse Collins, LBA
• Community Physicians Services Corporation
• Community Physicians Services Corporation
• Community Physicians Services Corporation
• Community Physicians Services Corporation
• Community Physicians Services Corporation

• Durable Medical Equipment & Medical Supplies in Norton, VA
• Providers in Norton, VA by specialty
• Durable Medical Equipment & Medical Supplies in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.