Healthcare Provider Details

I. General information

NPI: 1245548254
Provider Name (Legal Business Name): HOWARD-WILSON STARZ, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2010
Last Update Date: 09/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 FAIRHOOPE RD
WOODBRIDGE VA
22193
US

IV. Provider business mailing address

3800 FAIRHOOPE RD
WOODBRIDGE VA
22193
US

V. Phone/Fax

Practice location:
  • Phone: 571-330-9632
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE C. HOWARD-WILSON
Title or Position: HOME HEALTH CARE AIDE
Credential:
Phone: 571-330-9632