Provider Demographics
NPI:1154908564
Name:PMI HOME HEALTH NURSING, INC
Entity type:Organization
Organization Name:PMI HOME HEALTH NURSING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MACLEOD
Authorized Official - Middle Name:
Authorized Official - Last Name:IGHODALO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:804-234-3540
Mailing Address - Street 1:PO BOX 2808
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-8453
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10107 KRAUSE RD STE 100
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6506
Practice Address - Country:US
Practice Address - Phone:804-234-3540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty