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NPI Code Detail

MEDICARE: SEACREST HOME HEALTH AGENCY, INC.

MEDICARE: SEACREST HOME HEALTH AGENCY, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1063963270
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEACREST HOME HEALTH AGENCY, INC.
Provider Business Mailing Address
First Line : 5215 COLLEY AVE STE 102
Second Line :
City : NORFOLK
State : VA
Zip : 23508-2043
Country : US
Telephone Number : 757-321-4885
Fax Number : 757-321-4605
Provider Business Practice Location Address
First Line : 5215 COLLEY AVE STE 102
Second Line :
City : NORFOLK
State : VA
Zip : 23508-2043
Country : US
Telephone Number : 757-321-4885
Fax Number : 757-321-4605
Authorized Official
Title or Position : ADMINISTRATOR
Name : BOND OJI
Credential : RN
Telephone Number : 575-321-4885
Provider Enumeration Date : 10/23/2016
Last Update Date : 10/23/2016

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Directions to “SEACREST HOME HEALTH AGENCY, INC. ” Practice Location

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