# NORTHERN HOME CARE - CANA DIVISION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417940669
- **Authorized official:** MR. ANTHONY J. ZIZZAMIA JR. RN (PRESIDENT/EXECUTIVE DIRECTOR)
- **Authorized official phone:** (910) 815-3122

## Contact information

- **Practice address:** 15397 FANCY GAP HWY, SUITE 2, CANA, VA 24317-3635
- **Practice address phone:** (276) 755-4766
- **Practice address fax:** (276) 755-4225
- **Mailing address:** 2334 S 41ST ST, WILMINGTON, NC 28403-5502
- **Mailing address phone:** (910) 815-3122
- **Mailing address fax:** (910) 815-3111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | N/A | VA | Yes |

## Other

- **Enumeration date:** 08/23/2005
- **Last updated:** 05/04/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004973259 | — | VA |
| 01 | — | 442206 | ANTHEM | VA |