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General NPI Number Information
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NPI Number | 1912623943
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Entity Type | Organization
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Legal Business Name | EXCELSIOR INFUSION & HOME CARE LLC
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Dates
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Enumeration Date | 10/12/2022
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Last Update Date | 10/12/2022
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Provider Practice Location Address
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Address Line | 1545 CROSSWAYS BLVD STE 250
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City | CHESAPEAKE
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State | VA
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Zip | 23320-0218
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Country | US
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Telephone | 757-383-3208
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Fax |
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Provider Business Mailing Address
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Address Line | 1066 LEVEL GREEN BLVD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-4509
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Country | US
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Telephone | 757-704-4406
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | CARYN ADDERLEY
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Credential |
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Telephone | 757-383-3208
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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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