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General NPI Number Information
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NPI Number | 1306830559
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Entity Type | Organization
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Legal Business Name | HOME NURSING SERVICE OF SOUTHWEST VIRGINIA, INC.
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Dates
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Enumeration Date | 09/02/2005
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Last Update Date | 02/27/2012
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Provider Practice Location Address
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Address Line | 611 CAMPUS DR SUITE 300
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City | ABINGDON
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State | VA
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Zip | 24210-9700
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Country | US
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Telephone | 276-628-2666
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Fax | 276-623-4276
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Provider Business Mailing Address
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Address Line | 611 CAMPUS DR SUITE 300
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City | ABINGDON
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State | VA
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Zip | 24210-9700
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Country | US
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Telephone | 276-628-2666
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Fax | 276-623-4276
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. JUDY L. WILSON
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Credential | LPN
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Telephone | 276-628-2666
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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 | 0000364000402
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License Number State | VA
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