=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518316769
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PRECIOUS NURSING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/08/2016
-----------------------------------------------------
Last Update Date | 06/30/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 924 ARNETT BVLD.
-----------------------------------------------------
City | DANVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24540
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-549-5237
-----------------------------------------------------
Fax | 434-529-5239
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 924 ARNETT BVLD.
-----------------------------------------------------
City | DANVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24540
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-549-5237
-----------------------------------------------------
Fax | 434-529-5239
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LPN/ OWNER/ OPERATOR
-----------------------------------------------------
Name | MRS. SABRINA SAUNDERS WOOD
-----------------------------------------------------
Credential | LPN, OWNER
-----------------------------------------------------
Telephone | 434-549-5237
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 372500000X
-----------------------------------------------------
Taxonomy Name | Chore Provider
-----------------------------------------------------
License Number | 0002078893
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------