Healthcare Provider Details

I. General information

NPI: 1861673071
Provider Name (Legal Business Name): HEALTH CARE SOLUTIONS-DME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20605 THIRD AVE
ETTRICK VA
23803-2005
US

IV. Provider business mailing address

PO BOX 580
COLONIAL HEIGHTS VA
23834-0580
US

V. Phone/Fax

Practice location:
  • Phone: 804-451-9359
  • Fax: 804-451-9360
Mailing address:
  • Phone: 804-451-9359
  • Fax: 804-451-9360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number332B00000X
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number33BC3200X
License Number StateVA

VIII. Authorized Official

Name: MRS. ANNETTE VERNELL WATTS-DAVIS
Title or Position: OWNER
Credential:
Phone: 804-526-8018