1518485085 NPI number — AMOREE HOME CARE LLC

Table of content: MRS. CORRIE BURR CLD (NPI 1205167145)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518485085 NPI number — AMOREE HOME CARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMOREE HOME CARE LLC
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:
1518485085
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1716
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KILMARNOCK
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22482-1716
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-758-2500
Provider Business Mailing Address Fax Number:
804-758-2507

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2324 GREYS POINT RD UNIT 10
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOPPING
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23169-2187
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-758-2500
Provider Business Practice Location Address Fax Number:
804-758-2507
Provider Enumeration Date:
09/06/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CHURCHILL
Authorized Official First Name:
YOLANDA
Authorized Official Middle Name:
DELVON
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
804-758-2500

Provider Taxonomy Codes

  • Taxonomy code: 385H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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