Healthcare Provider Details

I. General information

NPI: 1790528529
Provider Name (Legal Business Name): HEY DUDE HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2024
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4012 OLD BROOK RD APT A
RICHMOND VA
23227-4275
US

IV. Provider business mailing address

4012 OLD BROOK RD APT A
RICHMOND VA
23227-4275
US

V. Phone/Fax

Practice location:
  • Phone: 804-750-3468
  • Fax:
Mailing address:
  • Phone: 804-750-3468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. TRAVIS D WILKINS
Title or Position: CEO
Credential:
Phone: 804-750-3468