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General NPI Number Information
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NPI Number | 1124346135
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Entity Type | Organization
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Legal Business Name | TRIPLE DL, LTD
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Dates
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Enumeration Date | 05/14/2010
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Last Update Date | 05/14/2010
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Provider Practice Location Address
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Address Line | 4914 RADFORD AVE STE 303
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City | RICHMOND
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State | VA
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Zip | 23230-3538
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Country | US
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Telephone | 804-525-5120
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Fax | 804-525-5128
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Provider Business Mailing Address
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Address Line | 4914 RADFORD AVE STE 303
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City | RICHMOND
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State | VA
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Zip | 23230-3538
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Country | US
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Telephone | 804-525-5120
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Fax | 804-525-5128
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID B WHITE
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Credential | MBA
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Telephone | 804-525-5120
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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 | HCO10654
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | HCO10654
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | HCO10654
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License Number State | VA
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