MEDICARE: GLOBAL HAWK 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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1013516582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLOBAL HAWK LLC

Provider Business Mailing Address
First Line	:	285 MOCKS CREEK DR
Second Line	:
City	:	DANVILLE
State	:	KY
Zip	:	40422-9255
Country	:	US
Telephone Number	:	859-312-3550
Fax Number	:

Provider Business Practice Location Address
First Line	:	285 MOCKS CREEK DR
Second Line	:
City	:	DANVILLE
State	:	KY
Zip	:	40422-9255
Country	:	US
Telephone Number	:	859-312-3550
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CHARLES ALEX BURRUS
Credential	:
Telephone Number	:	859-312-3550

Provider Enumeration Date	:	10/25/2020
Last Update Date	:	10/25/2020

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