MEDICARE: CITY HEALTHCARE SERVICES, INC.

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	:	1720534662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY HEALTHCARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	7011 CALAMO ST STE 203
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22150-3510
Country	:	US
Telephone Number	:	571-405-6647
Fax Number	:	703-997-4074

Provider Business Practice Location Address
First Line	:	7011 CALAMO ST STE 203
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22150-3510
Country	:	US
Telephone Number	:	571-405-6647
Fax Number	:	703-997-4074

Authorized Official
Title or Position	:	RN
Name	:	MRS. VICTORIA CHIKA ONYEMEZIKEYA
Credential	:	DIRECTOR
Telephone Number	:	703-282-4782

Provider Enumeration Date	:	08/31/2016
Last Update Date	:	10/10/2018

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