MEDICARE: ANITA O AMOANI

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	HCO-0005400	VA

General Provider Information

NPI Number	:	1730925272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANITA O AMOANI

Provider Business Mailing Address
First Line	:	104 CORAL REEF CT
Second Line	:
City	:	STAFFORD
State	:	VA
Zip	:	22554-4506
Country	:	US
Telephone Number	:	571-382-8410
Fax Number	:	571-382-8000

Provider Business Practice Location Address
First Line	:	104 CORAL REEF CT
Second Line	:
City	:	STAFFORD
State	:	VA
Zip	:	22554-4506
Country	:	US
Telephone Number	:	571-382-8000
Fax Number	:	571-382-8000

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2024
Last Update Date	:	07/03/2024

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Directions to “ ANITA O AMOANI ” Practice Location

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