=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811665193
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WALKER'S HOME HEALTHCARE CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/01/2021
-----------------------------------------------------
Last Update Date | 09/01/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1819 W MAIN ST
-----------------------------------------------------
City | DANVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24541-5741
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 143-429-7793
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 225 SEDGEFIELD LN
-----------------------------------------------------
City | DANVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24541-6105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 143-442-9779
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/MANAGER
-----------------------------------------------------
Name | MELISSA K WALKER-JOHNSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 143-429-7793
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------