Organization
SHORE HOME CARE AGENCY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA MCMILLAN (PRESIDENT)
(804) 323-1731
Entity
Organization
Contact information
Practice address
31 N PROVIDENCE RD, NORTH CHESTERFIELD, VA 23235-5221
(804) 323-1731
(804) 323-1209
Mailing address
31 N PROVIDENCE RD, NORTH CHESTERFIELD, VA 23235-5221
(804) 323-1731
(804) 323-1209
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HCO 151092
VA
251E00000X
Home Health Agency
HCO151157
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0171755215
—
VA
05
—
0172742790
—
VA
05
—
0174023660
—
VA
Enumeration date
04/28/2015
Last updated
04/28/2015
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