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NPI Code Detail

MEDICARE: ISADA HEALTHCARE SERVICES, INC.

MEDICARE: ISADA HEALTHCARE SERVICES, 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
1251E00000XHome Health AgencyHCO-13947VA
23747P1801XPersonal Care Attendant
3385H00000XRespite Care
4163WC2100XContinence Care Registered Nurse

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1HCO-13947OTHERVAOFFICE OF LINCENSURE AND CERTIFICATION

General Provider Information

NPI Number : 1518300938
Entity Type Code : Organization
Provider Name (Legal Business Name) : ISADA HEALTHCARE SERVICES, INC.
Provider Business Mailing Address
First Line : 4355 RIDGEWOOD CENTER DR
Second Line :
City : WOODBRIDGE
State : VA
Zip : 22192-5308
Country : US
Telephone Number : 703-665-4479
Fax Number : 703-940-1116
Provider Business Practice Location Address
First Line : 4355 RIDGEWOOD CENTER DR
Second Line :
City : WOODBRIDGE
State : VA
Zip : 22192-5308
Country : US
Telephone Number : 703-665-4479
Fax Number : 703-940-1116
Authorized Official
Title or Position : RN, MSN, CEO
Name : MR. MUSA BANGURA
Credential :
Telephone Number : 703-665-4479
Provider Enumeration Date : 04/16/2013
Last Update Date : 05/23/2018

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Directions to “ISADA HEALTHCARE SERVICES, INC. ” Practice Location

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