Healthcare Provider Details

I. General information

NPI: 1982712295
Provider Name (Legal Business Name): OLD DOMINION HOME HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2006
Last Update Date: 05/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8014 MIDLOTHIAN TPKE SUITE 200
RICHMOND VA
23235-5291
US

IV. Provider business mailing address

8014 MIDLOTHIAN TPKE SUITE 200
RICHMOND VA
23235-5291
US

V. Phone/Fax

Practice location:
  • Phone: 804-745-5133
  • Fax: 804-745-5526
Mailing address:
  • Phone: 804-745-5133
  • Fax: 804-745-5526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number608
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0206008463
License Number StateVA

VIII. Authorized Official

Name: MS. ISABELLE HILLIARD
Title or Position: PRESIDENT/CEO
Credential: RN
Phone: 804-745-5133