MEDICARE: AT HOME CARE STAFFING-COLONIAL HEIGHTS

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	:	1982006425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AT HOME CARE STAFFING-COLONIAL HEIGHTS

Provider Business Mailing Address
First Line	:	3660 BOULEVARD STE D
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-1345
Country	:	US
Telephone Number	:	804-358-0631
Fax Number	:	540-302-8033

Provider Business Practice Location Address
First Line	:	3610 BOULEVARD STE C
Second Line	:	BATES BUILDING
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-1329
Country	:	US
Telephone Number	:	804-358-0631
Fax Number	:	804-497-2112

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	TAMMY L FRANEY
Credential	:
Telephone Number	:	804-358-0631

Provider Enumeration Date	:	09/16/2014
Last Update Date	:	12/14/2022

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