1346491974 NPI number — FREDERICKSBURG SENIOR CARE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346491974 NPI number — FREDERICKSBURG SENIOR CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FREDERICKSBURG SENIOR CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
VISITING ANGELS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346491974
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
108 WESTWOOD OFFICE PARK
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREDERICKSBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22401-5123
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-373-6906
Provider Business Mailing Address Fax Number:
540-899-9674

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
108 WESTWOOD OFFICE PARK
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREDERICKSBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22401-5123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-373-6906
Provider Business Practice Location Address Fax Number:
540-899-9674
Provider Enumeration Date:
10/01/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DICKEY
Authorized Official First Name:
CATHARINE
Authorized Official Middle Name:
FLYNN
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
540-373-6906

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HCO09305 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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