MEDICARE: VANTAGE CARE, 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	:	1912596693
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VANTAGE CARE, LLC

Provider Business Mailing Address
First Line	:	6159 SEWELLS POINT RD
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23513-3255
Country	:	US
Telephone Number	:	757-818-9118
Fax Number	:

Provider Business Practice Location Address
First Line	:	6159 SEWELLS POINT RD
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23513-3255
Country	:	US
Telephone Number	:	757-818-9118
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	STEVEN SERIO
Credential	:
Telephone Number	:	757-818-9118

Provider Enumeration Date	:	01/15/2021
Last Update Date	:	01/15/2021

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Directions to “VANTAGE CARE, LLC ” Practice Location

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