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General NPI Number Information
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NPI Number | 1285871228
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Entity Type | Organization
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Legal Business Name | CARE AT HOME LLC
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Dates
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Enumeration Date | 01/13/2009
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Last Update Date | 01/13/2009
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Provider Practice Location Address
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Address Line | 800 3RD ST 250
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City | HERNDON
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State | VA
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Zip | 20170-3272
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Country | US
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Telephone | 571-237-3842
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Fax |
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Provider Business Mailing Address
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Address Line | 800 3RD ST 250
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City | HERNDON
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State | VA
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Zip | 20170-3272
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Country | US
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Telephone | 571-237-3842
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | DR. SAMUELL ADDY
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Credential | PHARM.D.
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Telephone | 571-237-3842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | HCO-09512
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HCO-09512
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License Number State | VA
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