Healthcare Provider Details

I. General information

NPI: 1396309456
Provider Name (Legal Business Name): BURD HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2019
Last Update Date: 01/08/2020
Certification Date: 01/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 SUNSET RD
LAKE OZARK MO
65049-5220
US

IV. Provider business mailing address

274 N GOODMAN ST STE A403
ROCHESTER NY
14607-1182
US

V. Phone/Fax

Practice location:
  • Phone: 833-447-3326
  • Fax: 585-545-7470
Mailing address:
  • Phone: 585-484-1960
  • Fax: 585-545-7470

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

VIII. Authorized Official

Name: ADAM N BURDICK
Title or Position: OWNER
Credential:
Phone: 585-484-1960