Organization
NORTHERN HOME CARE - CANA DIVISION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY J. ZIZZAMIA JR. RN (PRESIDENT/EXECUTIVE DIRECTOR)
(910) 815-3122
Entity
Organization
Contact information
Practice address
15397 FANCY GAP HWY, SUITE 2, CANA, VA 24317-3635
(276) 755-4766
(276) 755-4225
Mailing address
2334 S 41ST ST, WILMINGTON, NC 28403-5502
(910) 815-3122
(910) 815-3111
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
N/A
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004973259
—
VA
01
—
442206
ANTHEM
VA
Enumeration date
08/23/2005
Last updated
05/04/2009
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