Healthcare Provider Details

I. General information

NPI: 1962607192
Provider Name (Legal Business Name): ADORATION HOME HEALTH CARE VIRGINIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 08/17/2020
Certification Date: 08/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 PLAZA ROAD SUITE 20
WISE VA
24293-4613
US

IV. Provider business mailing address

805 N WHITTINGTON PKWY
LOUISVILLE KY
40222-7101
US

V. Phone/Fax

Practice location:
  • Phone: 276-679-6247
  • Fax: 800-311-7783
Mailing address:
  • Phone: 502-630-7425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberTO BE ISSUED
License Number StateVA

VIII. Authorized Official

Name: MARGARET PEMBERTON
Title or Position: VICE PRESIDENT
Credential:
Phone: 502-394-2321