MEDICARE: F.C. OF VIRGINIA, 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

General Provider Information

NPI Number	:	1265190573
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	F.C. OF VIRGINIA, INC.

Provider Business Mailing Address
First Line	:	3220 KELLER SPRINGS RD STE 108
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75006-5911
Country	:	US
Telephone Number	:	214-445-3750
Fax Number	:

Provider Business Practice Location Address
First Line	:	165 MARKET ST STE 2
Second Line	:
City	:	ONANCOCK
State	:	VA
Zip	:	23417-4233
Country	:	US
Telephone Number	:	757-787-7202
Fax Number	:

Authorized Official
Title or Position	:	CCO
Name	:	ROBERT PARKER
Credential	:
Telephone Number	:	214-445-3773

Provider Enumeration Date	:	12/03/2021
Last Update Date	:	08/29/2022

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