Healthcare Provider Details

I. General information

NPI: 1740547512
Provider Name (Legal Business Name): HLA HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2012
Last Update Date: 04/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5644 PERSON ST
SUFFOLK VA
23435-2537
US

IV. Provider business mailing address

5644 PERSON ST
SUFFOLK VA
23435-2537
US

V. Phone/Fax

Practice location:
  • Phone: 757-735-4749
  • Fax:
Mailing address:
  • Phone: 757-735-4749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. HERMAN LEE ALMOND
Title or Position: HLA HEALTH CARE
Credential:
Phone: 757-735-4749