Healthcare Provider Details

I. General information

NPI: 1679178180
Provider Name (Legal Business Name): MAYFAIR 2 HOMEHEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2020
Last Update Date: 12/02/2020
Certification Date: 12/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7245 HARROW RD
WARRENTON VA
20187-5807
US

IV. Provider business mailing address

7245 HARROW RD
WARRENTON VA
20187-5807
US

V. Phone/Fax

Practice location:
  • Phone: 703-989-9307
  • Fax: 540-216-7773
Mailing address:
  • Phone: 703-989-9307
  • Fax: 540-216-7773

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 Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MABEL TWUMASI
Title or Position: REGISTERED MEDICATION TECHNICIAN
Credential:
Phone: 703-989-9307