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General NPI Number Information
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NPI Number | 1396001301
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Entity Type | Organization
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Legal Business Name | AT HOME HEALTHCARE OF VIRGINIA
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Dates
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Enumeration Date | 04/03/2012
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Last Update Date | 04/03/2012
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Provider Practice Location Address
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Address Line | 9827 COGDILL RD SUITE 6
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City | KNOXVILLE
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State | TN
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Zip | 37932-3376
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Country | US
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Telephone | 865-247-5645
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Fax |
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Provider Business Mailing Address
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Address Line | 9827 COGDILL RD SUITE 6
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City | KNOXVILLE
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State | TN
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Zip | 37932-3376
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Country | US
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Telephone | 865-247-5645
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. SHAWN DAVID SPIVEY
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Credential |
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Telephone | 423-284-3705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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