Healthcare Provider Details

I. General information

NPI: 1649663980
Provider Name (Legal Business Name): DIRECT HOME HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2015
Last Update Date: 03/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 THIMBLE SHOALS BLVD SUITE 3A
NEWPORT NEWS VA
23606-4217
US

IV. Provider business mailing address

729 THIMBLE SHOALS BLVD SUITE 3A
NEWPORT NEWS VA
23606-4217
US

V. Phone/Fax

Practice location:
  • Phone: 757-405-6320
  • Fax: 757-673-5762
Mailing address:
  • Phone: 757-405-6320
  • Fax: 757-673-5762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCO15760
License Number StateVA

VIII. Authorized Official

Name: TROY FERNANDO ILAPIT
Title or Position: PRESIDENT
Credential: REGISTERED NURSE
Phone: 757-405-6320