MEDICARE: GOLDEN LIFE HOME CARE

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	:	1548642739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN LIFE HOME CARE

Provider Business Mailing Address
First Line	:	9281A 1ST VIEW ST
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23503-4225
Country	:	US
Telephone Number	:	757-375-3032
Fax Number	:

Provider Business Practice Location Address
First Line	:	9281A 1ST VIEW ST
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23503-4225
Country	:	US
Telephone Number	:	757-375-3032
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTINE HILLQUIST
Credential	:
Telephone Number	:	757-375-3032

Provider Enumeration Date	:	06/24/2015
Last Update Date	:	06/24/2015

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Directions to “GOLDEN LIFE HOME CARE ” Practice Location

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