MEDICARE: KC&J HOME HEALTH CARE SERVICES

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	:	1427692243
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KC&J HOME HEALTH CARE SERVICES

Provider Business Mailing Address
First Line	:	4925 ORLEANS DR
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23703-2113
Country	:	US
Telephone Number	:	757-439-8211
Fax Number	:

Provider Business Practice Location Address
First Line	:	4925 ORLEANS DR
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23703-2113
Country	:	US
Telephone Number	:	757-439-8211
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	TRACEY THORNE
Credential	:
Telephone Number	:	757-439-8211

Provider Enumeration Date	:	11/05/2019
Last Update Date	:	11/05/2019

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Directions to “KC&J HOME HEALTH CARE SERVICES ” Practice Location

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