Healthcare Provider Details

I. General information

NPI: 1649087164
Provider Name (Legal Business Name): DELMARVA HOME HEALTH AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2024
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 WALNUT ST
POCOMOKE CITY MD
21851-1621
US

IV. Provider business mailing address

807 WALNUT ST
POCOMOKE CITY MD
21851-1621
US

V. Phone/Fax

Practice location:
  • Phone: 443-978-0425
  • Fax:
Mailing address:
  • Phone: 443-978-0425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code364SH0200X
TaxonomyHome Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: MS. MARIETTA J WARD
Title or Position: CEO
Credential: LPN
Phone: 443-978-0425