Organization
J K M EXTENDED HOMEHEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMAR M BIVINS (PRESIDENT)
(757) 338-0803
Entity
Organization
Contact information
Practice address
320 BEN ST, SUFFOLK, VA 23434-3106
(757) 338-0803
Mailing address
320 BEN ST, SUFFOLK, VA 23434-3106
(757) 338-0803
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
11/02/2023
Last updated
11/02/2023
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