MEDICARE: DEQUINTON RAMON BAKER

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-222661	VA

Other Identifiers

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

General Provider Information

NPI Number	:	1154085439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEQUINTON RAMON BAKER

Provider Business Mailing Address
First Line	:	4317 BONNEY RD STE 2
Second Line	:
City	:	VIRGINIA BCH
State	:	VA
Zip	:	23452-1235
Country	:	US
Telephone Number	:	757-904-1543
Fax Number	:

Provider Business Practice Location Address
First Line	:	4317 BONNEY RD STE 2
Second Line	:
City	:	VIRGINIA BCH
State	:	VA
Zip	:	23452-1235
Country	:	US
Telephone Number	:	757-904-1543
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2021
Last Update Date	:	10/23/2021

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Directions to “ DEQUINTON RAMON BAKER ” Practice Location

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