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General NPI Number Information
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NPI Number | 1023343431
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Entity Type | Organization
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Legal Business Name | POTOMAC HOME HEALTHCARE, LLC
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Dates
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Enumeration Date | 10/03/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3931 AVION PARK CT STE C116
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City | CHANTILLY
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State | VA
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Zip | 20151-3983
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Country | US
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Telephone | 703-399-1485
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Fax |
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Provider Business Mailing Address
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Address Line | 3931 AVION PARK CT STE C116
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City | CHANTILLY
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State | VA
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Zip | 20151-3983
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Country | US
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Telephone | 703-399-1485
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. ABDIRAHAMAN M. ABDI
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Credential |
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Telephone | 703-399-1485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | VA
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