MEDICARE: HEALTH-PRO HOMECARE SERVICES, INC.

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	HCO-1135	VA

General Provider Information

NPI Number	:	1053739078
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH-PRO HOMECARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	400 SOUTHLAKE BLVD
Second Line	:	SUITE D
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23236-3061
Country	:	US
Telephone Number	:	804-464-2401
Fax Number	:	804-893-4703

Provider Business Practice Location Address
First Line	:	400 SOUTHLAKE BLVD
Second Line	:	SUITE D
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23236-3061
Country	:	US
Telephone Number	:	804-464-2401
Fax Number	:	804-893-4703

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. SYLVESTER BAILEY III
Credential	:	MBA
Telephone Number	:	252-702-1370

Provider Enumeration Date	:	04/07/2014
Last Update Date	:	05/11/2016

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