MEDICARE: OPTIMISM HOME HEALTH CARE SERVICES, 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467075424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMISM HOME HEALTH CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	1403 AIR RAIL AVE
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-3001
Country	:	US
Telephone Number	:	757-440-3415
Fax Number	:

Provider Business Practice Location Address
First Line	:	1403 AIR RAIL AVE
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-3001
Country	:	US
Telephone Number	:	757-440-3415
Fax Number	:

Authorized Official
Title or Position	:	OWNR
Name	:	MR. JAMES ANTHONY WEST SR.
Credential	:
Telephone Number	:	757-440-3365

Provider Enumeration Date	:	05/26/2020
Last Update Date	:	06/02/2020

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