MEDICARE: KASEY CARES LLC

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	251F00000X	Home Infusion Agency	HCO161384	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	S6202321	OTHER	VA	VIRGINIA SCC

General Provider Information

NPI Number	:	1174079826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KASEY CARES LLC

Provider Business Mailing Address
First Line	:	2920 W BROAD ST. STE 109
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-5103
Country	:	US
Telephone Number	:	804-447-9227
Fax Number	:

Provider Business Practice Location Address
First Line	:	2920 W BROAD ST. STE 109
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-5103
Country	:	US
Telephone Number	:	804-447-9227
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. DAVID MICHAEL BICKEL
Credential	:
Telephone Number	:	804-447-9227

Provider Enumeration Date	:	08/31/2016
Last Update Date	:	08/31/2016

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