Provider Demographics
NPI:1285985127
Name:VIRGINIA HOME HEALTH & HOSPICE CARE, INC.
Entity type:Organization
Organization Name:VIRGINIA HOME HEALTH & HOSPICE CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF HOME HEALTH OPERATIONS
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-BC
Authorized Official - Phone:703-201-1264
Mailing Address - Street 1:325 E MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-2300
Mailing Address - Country:US
Mailing Address - Phone:276-686-6321
Mailing Address - Fax:276-686-6160
Practice Address - Street 1:325 E MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-2300
Practice Address - Country:US
Practice Address - Phone:276-686-6321
Practice Address - Fax:276-686-6160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-01
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
49D0974181OtherCLIA
VA1285985127Medicaid
VA6500003OtherACHC AOID#
VA004970748Medicaid
VA497563OtherCCN/PTAN MEDICIARE