MEDICARE: GOVA HEALTHCARE SERVICES LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	163WH0200X	Home Health Registered Nurse
2	164W00000X	Licensed Practical Nurse
3	251J00000X	Nursing Care Agency
4	374U00000X	Home Health Aide
5	376K00000X	Nurse's Aide
6	385H00000X	Respite Care
7	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1689483927
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOVA HEALTHCARE SERVICES LLC.

Provider Business Mailing Address
First Line	:	12233 ARNESON ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27614-6962
Country	:	US
Telephone Number	:	919-949-8956
Fax Number	:

Provider Business Practice Location Address
First Line	:	9350 FALLS OF NEUSE RD STE 201
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27615-2481
Country	:	US
Telephone Number	:	919-949-8956
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CHIEF EXECUTIVE OFFICER
Name	:	CHIKE IFEDIORAH
Credential	:
Telephone Number	:	919-949-8956

Provider Enumeration Date	:	01/02/2025
Last Update Date	:	03/24/2025

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Directions to “GOVA HEALTHCARE SERVICES LLC. ” Practice Location

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