MEDICARE: OVAL HEALTH 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1184094617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OVAL HEALTH LLC

Provider Business Mailing Address
First Line	:	5216 WINDING BANK RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-6810
Country	:	US
Telephone Number	:	757-773-1771
Fax Number	:

Provider Business Practice Location Address
First Line	:	5216 WINDING BANK RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-6810
Country	:	US
Telephone Number	:	757-773-1771
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	AYANNA WILSON JAMES
Credential	:
Telephone Number	:	757-773-1771

Provider Enumeration Date	:	09/27/2015
Last Update Date	:	09/27/2015

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Directions to “OVAL HEALTH LLC ” Practice Location

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