Provider Demographics
NPI:1891517629
Name:VALUEVINE COMPANY LLC
Entity type:Organization
Organization Name:VALUEVINE COMPANY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADEKUNLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEWUYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-497-6070
Mailing Address - Street 1:1522 WILLOW BRANCH WAY
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-6829
Mailing Address - Country:US
Mailing Address - Phone:804-497-6070
Mailing Address - Fax:443-645-6900
Practice Address - Street 1:1522 WILLOW BRANCH WAY
Practice Address - Street 2:
Practice Address - City:SEVERN
Practice Address - State:MD
Practice Address - Zip Code:21144-6829
Practice Address - Country:US
Practice Address - Phone:804-497-6070
Practice Address - Fax:443-645-6900
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALUEVINE HEALTH CARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-31
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health