Healthcare Provider Details

I. General information

NPI: 1932373065
Provider Name (Legal Business Name): SUREFIRE HEALTH CARE PROFESSIONALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2008
Last Update Date: 09/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 E CAROLINA AVE
CREWE VA
23930-1802
US

IV. Provider business mailing address

124 E CAROLINA AVE
CREWE VA
23930-1802
US

V. Phone/Fax

Practice location:
  • Phone: 434-538-0120
  • Fax: 434-538-0121
Mailing address:
  • Phone: 434-538-0120
  • Fax: 434-538-0121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCO-11671
License Number StateVA

VIII. Authorized Official

Name: MS. DEBORAH JANE VIEIRA
Title or Position: OWNER
Credential:
Phone: 540-848-0183