Healthcare Provider Details

I. General information

NPI: 1699157388
Provider Name (Legal Business Name): DREAM CARE OF VA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2015
Last Update Date: 10/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7650 E PARHAM RD STE. 222
HENRICO VA
23294-4373
US

IV. Provider business mailing address

3325 BARTLETT BLVD
ORLANDO FL
32811-6428
US

V. Phone/Fax

Practice location:
  • Phone: 804-286-1840
  • Fax:
Mailing address:
  • Phone: 407-206-0040
  • Fax: 407-206-0010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN GRIGGS
Title or Position: CEO
Credential:
Phone: 407-206-0040