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Organization

PEDIALAC NURSING SERVICES LLC

Active
Other names
PEDIALAC NURSING SERVICES
Organization subpart
No

Provider details

NPI number
Authorized official
ELIZABETH AMA CLARKE RN (ADMINSTRATOR)
(540) 737-4010
Entity
Organization

Contact information

Practice address
1127 INTERNATIONAL PKWY STE 220, FREDERICKSBRG, VA 22406-1142
(540) 737-4010
(540) 737-4011
Mailing address
1127 INTERNATIONAL PKWY STE 220, FREDERICKSBRG, VA 22406-1142
(540) 737-4010
(540) 737-4011

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HCO 161444
VA
251E00000X
Home Health Agency

Other

Enumeration date
05/06/2016
Last updated
10/19/2021
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