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General NPI Number Information
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NPI Number | 1164018875
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Entity Type | Organization
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Legal Business Name | PEARL HEALTHCARE INC
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Dates
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Enumeration Date | 12/16/2020
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Last Update Date | 12/16/2020
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Provider Practice Location Address
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Address Line | 4601 FAIRFAX DR
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City | ARLINGTON
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State | VA
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Zip | 22203-1527
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Country | US
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Telephone | 571-370-9060
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Fax | 757-231-3126
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Provider Business Mailing Address
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Address Line | 4601 FAIRFAX DR
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City | ARLINGTON
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State | VA
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Zip | 22203-1527
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Country | US
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Telephone | 571-370-9060
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Fax | 757-231-3126
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Authorized Official
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Title or Position | CEO
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Name | ELVIS MAGORI
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Credential |
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Telephone | 301-213-0657
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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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