Healthcare Provider Details

I. General information

NPI: 1811255359
Provider Name (Legal Business Name): SURPASSION HEALTHCARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2012
Last Update Date: 09/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4820 SOUTHPOINT DR STE 203
FREDERICKSBURG VA
22407-2614
US

IV. Provider business mailing address

5006 STRAUSS CT
FREDERICKSBURG VA
22407-7776
US

V. Phone/Fax

Practice location:
  • Phone: 540-412-5529
  • Fax: 540-412-5563
Mailing address:
  • Phone: 540-479-2552
  • Fax: 540-412-5563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberHCO-14985
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code163WC2100X
TaxonomyContinence Care Registered Nurse
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberHCO-14985
License Number StateVA
# 8
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License NumberHCO-14985
License Number StateVA
# 9
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberHCO-14985
License Number StateVA
# 10
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. FLORA ANN SMITH
Title or Position: EI SERVICE COORDINATOR
Credential: CEO, ADMINISTRATOR
Phone: 540-412-5529