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NPI Code Detail

MEDICARE: CONGLAMORATE HOME HEALTHCARE, LLC

MEDICARE: CONGLAMORATE HOME HEALTHCARE, 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 AgencyHCO161295VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033595616
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONGLAMORATE HOME HEALTHCARE, LLC
Provider Business Mailing Address
First Line : 1036 32ND ST
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23607-3508
Country : US
Telephone Number : 757-247-1268
Fax Number : 757-247-0982
Provider Business Practice Location Address
First Line : 1036 32ND ST
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23607-3508
Country : US
Telephone Number : 757-247-1268
Fax Number : 757-247-0982
Authorized Official
Title or Position : OWNER
Name : RYSHEN EURE
Credential :
Telephone Number : 757-277-2509
Provider Enumeration Date : 08/05/2015
Last Update Date : 08/05/2015

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Directions to “CONGLAMORATE HOME HEALTHCARE, LLC ” Practice Location

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