# COMMONWEALTH HOME HEALTH INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** 1st Care Home Health South Boston
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487646113
- **Authorized official:** MR. ALFRED LEE BURKHOLD III (ADMINISTRATOR)
- **Authorized official phone:** (434) 572-1582

## Contact information

- **Practice address:** 425 MAIN ST, SOUTH BOSTON, VA 24592-3241
- **Practice address phone:** (434) 572-1312
- **Practice address fax:** (434) 572-6211
- **Mailing address:** PO BOX 1006, SOUTH BOSTON, VA 24592-1006
- **Mailing address phone:** (434) 572-1312
- **Mailing address fax:** (434) 572-6211

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 08/18/2005
- **Last updated:** 11/20/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 226503 | ANTHEM | VA |
| 05 | — | 4970217 | — | VA |