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Organization

PROFESSIONAL HOME HEALTH CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SEMEIKO GAMBRELL (ADMINISTRATOR)
(757) 238-9888
Entity
Organization

Contact information

Practice address
15207 CARROLLTON BLVD, CARROLLTON, VA 23314-2303
(757) 238-9888
Mailing address
15207 CARROLLTON BLVD, CARROLLTON, VA 23314-2303
(757) 238-9888

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HOC-151063
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0172515899
VA
05
0172516350
VA
Enumeration date
07/07/2015
Last updated
07/07/2015
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