MEDICARE: HEY DUDE HOME HEALTH 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1790528529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEY DUDE HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	4012 OLD BROOK RD APT A
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23227-4275
Country	:	US
Telephone Number	:	804-750-3468
Fax Number	:

Provider Business Practice Location Address
First Line	:	4012 OLD BROOK RD APT A
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23227-4275
Country	:	US
Telephone Number	:	804-750-3468
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. TRAVIS D WILKINS
Credential	:
Telephone Number	:	804-750-3468

Provider Enumeration Date	:	06/18/2024
Last Update Date	:	06/18/2024

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