Healthcare Provider Details

I. General information

NPI: 1154371144
Provider Name (Legal Business Name): S & S HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 06/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3235 VIRGINIA AVE
COLLINSVILLE VA
24078-2241
US

IV. Provider business mailing address

2747 PENN FOREST BLVD
ROANOKE VA
24018-4342
US

V. Phone/Fax

Practice location:
  • Phone: 276-647-1700
  • Fax: 276-647-4990
Mailing address:
  • Phone: 540-774-8686
  • Fax: 540-774-0279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY LYNN PETESEN
Title or Position: CEO/OWNER
Credential:
Phone: 540-774-8686