Healthcare Provider Details

I. General information

NPI: 1528405768
Provider Name (Legal Business Name): HANDS 4 HOME DIALYSIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2013
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 MILL RIDGE RD
LYNCHBURG VA
24502-4341
US

IV. Provider business mailing address

147 MILL RIDGE RD
LYNCHBURG VA
24502-4341
US

V. Phone/Fax

Practice location:
  • Phone: 434-239-4443
  • Fax:
Mailing address:
  • Phone: 434-609-4443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA L BROOKMAN
Title or Position: OWNER
Credential:
Phone: 434-239-4443