1285676510 NPI number — HOMECALL, INC

Table of content: (NPI 1285676510)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285676510 NPI number — HOMECALL, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOMECALL, 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:
1285676510
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1080 W PATRICK ST
Provider Second Line Business Mailing Address:
SUITE 1043
Provider Business Mailing Address City Name:
FREDERICK
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21703-3972
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-444-0097
Provider Business Mailing Address Fax Number:
301-644-2990

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
722 E MARKET ST
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
LEESBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20176-4475
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-949-7062
Provider Business Practice Location Address Fax Number:
703-779-0152
Provider Enumeration Date:
06/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ESWORTHY
Authorized Official First Name:
ARTIE
Authorized Official Middle Name:
ROBERT
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
800-444-0097

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  497250 , 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: 4972503 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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