Organization
PAVILION MEDICAL HOME CARE & STAFFING, LLC
Active
Parent organization
PAVILION MEDICAL HOME CARE & STAFFING, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PAVILION MEDICAL HOME CARE & STAFFING, LLC
Authorized official
MR. GIBSON IYEKE ERHUNMWUNSE CRNP (CEO)
(703) 299-9898
Entity
Organization
Contact information
Practice address
4115 ANNANDALE RD, SUITE 202, ANNANDALE, VA 22003-2500
(703) 299-9898
(703) 299-9595
Mailing address
4115 ANNANDALE RD, SUITE 202, ANNANDALE, VA 22003-2500
(703) 299-9898
(703) 299-9595
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HCO-O7389
VA
Other
Enumeration date
11/01/2006
Last updated
02/22/2012
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