Healthcare Provider Details

I. General information

NPI: 1669172748
Provider Name (Legal Business Name): MEDSY HEALTH IN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2023
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441B CARLISLE DR # 202
HERNDON VA
20170-4802
US

IV. Provider business mailing address

441B CARLISLE DR # 202
HERNDON VA
20170-4802
US

V. Phone/Fax

Practice location:
  • Phone: 703-303-8525
  • Fax: 703-303-8525
Mailing address:
  • Phone: 703-303-8525
  • Fax: 703-303-8525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. FANY MAPPAH
Title or Position: CEO
Credential: QA/QI
Phone: 703-303-8525