MEDICARE: ANN MASON 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	385H00000X	Respite Care		VA
2	251E00000X	Home Health Agency		VA

General Provider Information

NPI Number	:	1629436613
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANN MASON HOME CARE

Provider Business Mailing Address
First Line	:	464 INVESTORS PL STE 102
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-1167
Country	:	US
Telephone Number	:	757-918-8972
Fax Number	:	757-456-2714

Provider Business Practice Location Address
First Line	:	464 INVESTORS PL STE 102
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-1167
Country	:	US
Telephone Number	:	757-918-8972
Fax Number	:	757-456-2714

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KESHA MASON
Credential	:
Telephone Number	:	757-918-8972

Provider Enumeration Date	:	02/04/2016
Last Update Date	:	02/04/2016

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Practice Location Address:

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Directions to “ANN MASON HOME CARE ” Practice Location

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