MEDICARE: BLUESTAR HOME HEALTH CARE LLC

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	251F00000X	Home Infusion Agency	171347	VA
2	251G00000X	Community Based Hospice Care Agency
3	251J00000X	Nursing Care Agency	171347	VA
4	253Z00000X	In Home Supportive Care Agency	171347	VA
5	385H00000X	Respite Care
6	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	171347	OTHER	VA	VA DEPARTMENT OF HEALTH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962894717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUESTAR HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	5613 LEESBURG PIKE STE 55
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22041-2912
Country	:	US
Telephone Number	:	703-829-0719
Fax Number	:	703-646-7558

Provider Business Practice Location Address
First Line	:	5613 LEESBURG PIKE STE 55
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22041-2912
Country	:	US
Telephone Number	:	703-829-0719
Fax Number	:	703-646-7558

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ISMAHAN AHMED
Credential	:	RN
Telephone Number	:	703-829-0719

Provider Enumeration Date	:	03/02/2015
Last Update Date	:	03/17/2018

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Directions to “BLUESTAR HOME HEALTH CARE LLC ” Practice Location

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