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General NPI Number Information
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NPI Number | 1184098394
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Entity Type | Organization
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Legal Business Name | AVAVA NURSING SERVICES INC
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Dates
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Enumeration Date | 11/26/2015
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Last Update Date | 11/26/2015
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Provider Practice Location Address
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Address Line | 630 FREEDOM BUSINESS CTR DR THIRD FLOOR
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-1331
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Country | US
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Telephone | 240-350-8192
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Fax |
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Provider Business Mailing Address
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Address Line | 8226 LONDONDERRY CT
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City | LAUREL
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State | MD
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Zip | 20707-5627
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Country | US
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Telephone | 240-350-8192
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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. VINCENT A UDEMBA
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Credential |
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Telephone | 240-350-8192
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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 | 28343601
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License Number State | PA
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