MEDICARE: MIDDLEBURG 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	385HR2065X	Child Physical Disabilities Respite Care
2	163W00000X	Registered Nurse	R111424	MD
3	225100000X	Physical Therapist
4	225200000X	Physical Therapy Assistant
5	225XP0019X	Physical Rehabilitation Occupational Therapist
6	251F00000X	Home Infusion Agency	HCO1668	VA
7	253Z00000X	In Home Supportive Care Agency	HCO1668	VA
8	332B00000X	Durable Medical Equipment & Medical Supplies
9	343900000X	Non-emergency Medical Transport (VAN)
10	3747P1801X	Personal Care Attendant	HCO181621	VA
11	374U00000X	Home Health Aide
12	385H00000X	Respite Care
13	385HR2055X	Child Mental Illness Respite Care
14	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
15	251E00000X	Home Health Agency	HCO1668	VA

Other Identifiers

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

General Provider Information

NPI Number	:	1770014839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDDLEBURG HOME CARE

Provider Business Mailing Address
First Line	:	PO BOX 544
Second Line	:
City	:	MIDDLEBURG
State	:	VA
Zip	:	20118-0544
Country	:	US
Telephone Number	:	540-316-7515
Fax Number	:	540-277-2518

Provider Business Practice Location Address
First Line	:	6487 MAIN ST
Second Line	:
City	:	THE PLAINS
State	:	VA
Zip	:	20198
Country	:	US
Telephone Number	:	540-316-7515
Fax Number	:	540-277-2518

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MICHELLE LANE
Credential	:	RN
Telephone Number	:	540-316-7515

Provider Enumeration Date	:	03/21/2017
Last Update Date	:	05/17/2021

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Directions to “MIDDLEBURG HOME CARE ” Practice Location

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