Organization
TEAM NURSE, INC.
Active
Other names
Team Nurse Madison Heights
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN D. MIZE (PRESIDENT)
(434) 575-5200
Entity
Organization
Contact information
Practice address
4007 S AMHERST HWY, MADISON HEIGHTS, VA 24572-5947
(434) 929-1047
(434) 929-1049
Mailing address
PO BOX 776, SOUTH BOSTON, VA 24592-0776
(434) 575-5200
(434) 575-5054
Taxonomy
Speciality
Code
Description
License number
State
163WC2100X
Continence Care Registered Nurse
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
HCO-10442
VA
3747P1801X
Personal Care Attendant
Primary
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0151841241
—
VA
05
—
0151841753
—
VA
01
—
1316133739
MEDICAID PRIVATE DUTY NURSING
VA
01
—
HCO-09442
STATE LICENSURE
VA
Enumeration date
09/19/2007
Last updated
08/15/2019
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