Provider Demographics
NPI:1104213990
Name:AMERIHEALTH CARE, LLC
Entity type:Organization
Organization Name:AMERIHEALTH CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:ANIKWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-775-5502
Mailing Address - Street 1:10212 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:KING GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:22485-3429
Mailing Address - Country:US
Mailing Address - Phone:540-775-5502
Mailing Address - Fax:
Practice Address - Street 1:10212 KINGS HWY
Practice Address - Street 2:
Practice Address - City:KING GEORGE
Practice Address - State:VA
Practice Address - Zip Code:22485-3429
Practice Address - Country:US
Practice Address - Phone:540-775-5502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAADC1103658261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0156132976Medicaid