Healthcare Provider Details

I. General information

NPI: 1578648143
Provider Name (Legal Business Name): ESPRIT HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 06/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 MILLER DR SE SUITE F1
LEESBURG VA
20175-8916
US

IV. Provider business mailing address

750 MILLER DR SE SUITE F1
LEESBURG VA
20175-8916
US

V. Phone/Fax

Practice location:
  • Phone: 703-777-3389
  • Fax:
Mailing address:
  • Phone: 703-777-3389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0206008438
License Number StateVA

VIII. Authorized Official

Name: MR. ZELALEM B DAGNE
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 703-998-7400