MEDICARE: IRIS ALTU

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
1	374U00000X	Home Health Aide		VA

General Provider Information

NPI Number	:	1154261667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRIS ALTU

Provider Business Mailing Address
First Line	:	2031 BOOKER ST
Second Line	:
City	:	GLOUCESTER POINT
State	:	VA
Zip	:	23062-3663
Country	:	US
Telephone Number	:	757-800-7747
Fax Number	:

Provider Business Practice Location Address
First Line	:	2031 BOOKER ST
Second Line	:
City	:	GLOUCESTER POINT
State	:	VA
Zip	:	23062-3663
Country	:	US
Telephone Number	:	757-800-7747
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2026
Last Update Date	:	04/01/2026

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Directions to “ IRIS ALTU ” Practice Location

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