MEDICARE: ARNESTA HEALTHCARE OF VIRGINIA 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	251E00000X	Home Health Agency		VA

General Provider Information

NPI Number	:	1346609500
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARNESTA HEALTHCARE OF VIRGINIA LLC

Provider Business Mailing Address
First Line	:	PO BOX 6843
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-0843
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4912 W MARSHALL ST STE C
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-3127
Country	:	US
Telephone Number	:	804-214-2561
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RANDY REDD
Credential	:
Telephone Number	:	804-313-6767

Provider Enumeration Date	:	02/16/2016
Last Update Date	:	01/06/2018

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