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NPI Code Detail

MEDICARE: PERSONIC HEALTHCARE LLC

MEDICARE: PERSONIC HEALTHCARE 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
1163WW0000XWound Care Registered Nurse

Other Identifiers

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

General Provider Information

NPI Number : 1558033100
Entity Type Code : Organization
Provider Name (Legal Business Name) : PERSONIC HEALTHCARE LLC
Provider Business Mailing Address
First Line : PO BOX 8209
Second Line :
City : VIENNA
State : VA
Zip : 22183-2058
Country : US
Telephone Number : 251-901-3011
Fax Number : 251-901-3011
Provider Business Practice Location Address
First Line : 555 WINDERLEY PL STE 300
Second Line :
City : MAITLAND
State : FL
Zip : 32751-7133
Country : US
Telephone Number : 251-901-3011
Fax Number : 215-933-6837
Authorized Official
Title or Position : OWNER
Name : FAHAD HASHMI
Credential :
Telephone Number : 251-901-3011
Provider Enumeration Date : 10/01/2021
Last Update Date : 12/09/2024

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