Healthcare Provider Details

I. General information

NPI: 1104213990
Provider Name (Legal Business Name): AMERIHEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2015
Last Update Date: 04/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10212 KINGS HWY
KING GEORGE VA
22485-3429
US

IV. Provider business mailing address

10212 KINGS HWY
KING GEORGE VA
22485-3429
US

V. Phone/Fax

Practice location:
  • Phone: 540-775-5502
  • Fax:
Mailing address:
  • Phone: 540-775-5502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberADC1103658
License Number StateVA

VIII. Authorized Official

Name: EDITH ANIKWE
Title or Position: ADMINISTRATOR
Credential:
Phone: 540-775-5502