MEDICARE: RICHLANDS HOME CARE, 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	HCO360	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	49-7611	OTHER	VA	MEDICARE PROVIDER NUMBER

General Provider Information

NPI Number	:	1881649358
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHLANDS HOME CARE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 418
Second Line	:
City	:	RICHLANDS
State	:	VA
Zip	:	24641-0418
Country	:	US
Telephone Number	:	276-596-9536
Fax Number	:	276-596-9538

Provider Business Practice Location Address
First Line	:	2032 CEDAR VALLEY DRIVE
Second Line	:
City	:	CEDAR BLUFF
State	:	VA
Zip	:	24609-8753
Country	:	US
Telephone Number	:	276-596-9536
Fax Number	:	276-596-9538

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	TRISTA R BLANKENSHIP
Credential	:	RN
Telephone Number	:	276-596-9536

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	04/17/2023

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