1881649358 NPI number — RICHLANDS HOME CARE, INC.

Table of content: ERIC K VANDEPOL MD (NPI 1205843125)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881649358 NPI number — RICHLANDS HOME CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RICHLANDS HOME 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:
Provider Other Organization Name Type Code:
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:
1881649358
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

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

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2032 CEDAR VALLEY DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CEDAR BLUFF
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24609-8753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
276-596-9536
Provider Business Practice Location Address Fax Number:
276-596-9538
Provider Enumeration Date:
05/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BLANKENSHIP
Authorized Official First Name:
TRISTA
Authorized Official Middle Name:
R
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
276-596-9536

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HCO360 , 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)

  • Identifier: 49-7611 . This is a "MEDICARE PROVIDER NUMBER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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