MEDICARE: PURCELL HOLDINGS, L.L.C.

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1235681099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PURCELL HOLDINGS, L.L.C.

Provider Business Mailing Address
First Line	:	6710 OXON HILL RD
Second Line	:	SUITE 210
City	:	OXON HILL
State	:	MD
Zip	:	20745-1117
Country	:	US
Telephone Number	:	240-205-7188
Fax Number	:	240-414-1253

Provider Business Practice Location Address
First Line	:	1800 DIAGONAL RD
Second Line	:	SUITE 600
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-2840
Country	:	US
Telephone Number	:	240-205-7188
Fax Number	:	240-414-1253

Authorized Official
Title or Position	:	BOARD CHAIRMAN
Name	:	JOHN PURCELL JR.
Credential	:
Telephone Number	:	240-205-7188

Provider Enumeration Date	:	10/27/2016
Last Update Date	:	10/27/2016

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