Organization
PERSONAL HOMECARE INC
Active
Other names
1st Care at Home
Organization subpart
No
Provider details
NPI number
Authorized official
ALFRED LEE BURKHOLDER III (PRESIDENT)
(434) 572-1582
Entity
Organization
Contact information
Practice address
425 MAIN STREET, SOUTH BOSTON, VA 24592
(434) 572-1028
(434) 572-2631
Mailing address
425 MAIN STREET, SOUTH BOSTON, VA 24592
(434) 572-1028
(434) 572-2631
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
EXEMPT
VA
253Z00000X
In Home Supportive Care Agency
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
VA
333300000X
Emergency Response System Companies
—
—
385H00000X
Respite Care
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00875111
—
VA
05
—
009106235
—
VA
01
—
104815
PRIVATE DUTY NURSING
VA
05
—
8751013
—
VA
Enumeration date
11/03/2006
Last updated
11/20/2023
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