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General NPI Number Information
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NPI Number | 1497108567
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Entity Type | Organization
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Legal Business Name | THELMARELOUS HEALTHCARE AGENCY LLC
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 10/18/2016
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Provider Practice Location Address
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Address Line | 7122 FOREST HILL AVE
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City | RICHMOND
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State | VA
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Zip | 23225-1542
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Country | US
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Telephone | 804-836-8818
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Fax | 804-308-3304
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Provider Business Mailing Address
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Address Line | PO BOX 25083
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City | RICHMOND
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State | VA
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Zip | 23260-5083
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Country | US
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Telephone | 804-836-8818
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Fax | 804-308-3304
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. EVERLY THELME WALTON
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Credential | PH,D
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Telephone | 804-836-8818
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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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