MEDICARE: CONNANN 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	385H00000X	Respite Care
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1326551862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONNANN LLC

Provider Business Mailing Address
First Line	:	9512 IRON BRIDGE RD STE 200
Second Line	:
City	:	CHESTERFIELD
State	:	VA
Zip	:	23832-6458
Country	:	US
Telephone Number	:	804-410-1228
Fax Number	:	804-410-1228

Provider Business Practice Location Address
First Line	:	9512 IRON BRIDGE RD STE 200
Second Line	:
City	:	CHESTERFIELD
State	:	VA
Zip	:	23832-6458
Country	:	US
Telephone Number	:	804-410-1228
Fax Number	:	804-410-1228

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	TERESA PAIGE BRILHART
Credential	:
Telephone Number	:	804-410-1228

Provider Enumeration Date	:	11/07/2017
Last Update Date	:	06/16/2018

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Directions to “CONNANN LLC ” Practice Location

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