MEDICARE: KASEY 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	:	1548698681
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KASEY CARE

Provider Business Mailing Address
First Line	:	2920 W BROAD STREET
Second Line	:	SUITE 109
City	:	RICHMOND
State	:	VA
Zip	:	23230-5103
Country	:	US
Telephone Number	:	804-447-9227
Fax Number	:

Provider Business Practice Location Address
First Line	:	2920 W BROAD STREET
Second Line	:	SUITE 109
City	:	RICHMOND
State	:	VA
Zip	:	23230-5103
Country	:	US
Telephone Number	:	804-447-9227
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MR. DAVE MICHAEL BICKEL
Credential	:	COO
Telephone Number	:	804-852-6304

Provider Enumeration Date	:	10/29/2013
Last Update Date	:	10/31/2016

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