Healthcare Provider Details

I. General information

NPI: 1053507384
Provider Name (Legal Business Name): BESTWAY HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 09/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3707 VIRGINIA BEACH BLVD SUITE 218
VIRGINIA BEACH VA
23452-3412
US

IV. Provider business mailing address

3707 VIRGINIA BEACH BLVD SUITE 218
VIRGINIA BEACH VA
23452-3412
US

V. Phone/Fax

Practice location:
  • Phone: 757-340-2361
  • Fax: 757-340-7200
Mailing address:
  • Phone: 757-340-2361
  • Fax: 757-340-7200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number03-210
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID O ETUTE
Title or Position: OWNER
Credential:
Phone: 757-340-2361