MEDICARE: LINBAR HOME HEALTH AGENCY

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	0001210835	VA

General Provider Information

NPI Number	:	1356582274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINBAR HOME HEALTH AGENCY

Provider Business Mailing Address
First Line	:	1138 CLEAR SPRINGS RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-4920
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1138 CLEAR SPRINGS RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-4920
Country	:	US
Telephone Number	:	757-560-1262
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LINDA KAY FULLER
Credential	:	RN
Telephone Number	:	757-560-1262

Provider Enumeration Date	:	03/23/2009
Last Update Date	:	03/23/2009

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