Organization
PETERSBURG HOME CARE SERVICES LLC
Active
Other names
Southside Regional Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS GACHASSIN III (SECRETARY/TREASURER)
(501) 891-1044
Entity
Organization
Contact information
Practice address
601 OLD WAGNER RD BLDG A, PETERSBURG, VA 23805-9313
(804) 862-8345
(804) 862-3461
Mailing address
9510 ORMSBY STATION RD, STE 300, LOUISVILLE, KY 40223-4081
(502) 891-1187
(502) 891-8067
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
497072
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4970721
—
VA
Enumeration date
01/13/2006
Last updated
05/03/2022
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