Healthcare Provider Details
I. General information
NPI: 1609272616
Provider Name (Legal Business Name): LEADER HOME HEALTH CARE CORP.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/18/2014
Last Update Date: 11/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9501 DANIEL FRENCH ST
LORTON VA
22079-2352
US
IV. Provider business mailing address
9501 DANIEL FRENCH ST
LORTON VA
22079-2352
US
V. Phone/Fax
- Phone: 703-237-2182
- Fax: 703-237-0613
- Phone: 703-862-9282
- Fax: 703-237-0613
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
THU
ANH
BUI
Title or Position: OWNER/ DIRECTOR
Credential: DOCTOR OF PHARMACY
Phone: 703-862-9282