MEDICARE: AT EASE HOME CARE

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1356795348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AT EASE HOME CARE

Provider Business Mailing Address
First Line	:	4968 EUCLID RD
Second Line	:	SUITE A2
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-5833
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4968 EUCLID RD
Second Line	:	SUITE A-2
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462
Country	:	US
Telephone Number	:	757-963-0100
Fax Number	:	757-963-0681

Authorized Official
Title or Position	:	CEO
Name	:	MARYVONA CUFFEE
Credential	:
Telephone Number	:	757-963-0100

Provider Enumeration Date	:	04/16/2016
Last Update Date	:	04/11/2019

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