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General NPI Number Information
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NPI Number | 1093585382
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Entity Type | Organization
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Legal Business Name | BLUE CORD HEALTH AGENCY LLC
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Dates
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Enumeration Date | 01/08/2024
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 203 GRISHAM RD
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City | STAFFORD
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State | VA
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Zip | 22554-7383
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Country | US
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Telephone | 240-728-9632
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Fax |
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Provider Business Mailing Address
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Address Line | 203 GRISHAM RD
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City | STAFFORD
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State | VA
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Zip | 22554-7383
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Country | US
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Telephone | 240-728-9632
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | OSEI DAMTE-DAPAAH
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Credential |
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Telephone | 240-728-9632
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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 |
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