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NPI Code Detail

MEDICARE: INTERNAL LIFE HOMECARE LLC

MEDICARE: INTERNAL LIFE HOMECARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health AgencyVA

General Provider Information

NPI Number : 1013424472
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTERNAL LIFE HOMECARE LLC
Provider Business Mailing Address
First Line : 5660 E VIRGINIA BEACH BLVD STE 101
Second Line :
City : NORFOLK
State : VA
Zip : 23502-2468
Country : US
Telephone Number : 757-470-5798
Fax Number : 757-275-7580
Provider Business Practice Location Address
First Line : 5660 E VIRGINIA BEACH BLVD STE 101
Second Line :
City : NORFOLK
State : VA
Zip : 23502-2468
Country : US
Telephone Number : 757-470-5798
Fax Number : 757-275-7580
Authorized Official
Title or Position : OWNER
Name : MS. CIARA CASHAY ROBINSON
Credential :
Telephone Number : 757-977-2218
Provider Enumeration Date : 01/08/2018
Last Update Date : 01/08/2018

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