Healthcare Provider Details

I. General information

NPI: 1437683919
Provider Name (Legal Business Name): KATZ HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 04/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 BRIDGEWOOD CT UNIT B
STAFFORD VA
22554-7741
US

IV. Provider business mailing address

108 BRIDGEWOOD CT UNIT B
STAFFORD VA
22554-7741
US

V. Phone/Fax

Practice location:
  • Phone: 540-699-7225
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: VINCENT ANTHONY MARTIN JR.
Title or Position: HOME HEALTH AIDE PERSONAL CARE
Credential: CNA. PCA, EMT
Phone: 540-699-7225