Organization
COMMUNITY HOME CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARY LYNN KRUTAK (EVP/CFO)
(423) 302-3423
Entity
Organization
Contact information
Practice address
1490 PARK AVE NW STE 6, NORTON, VA 24273-1631
(276) 439-1460
(276) 439-1461
Mailing address
311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
(276) 439-1460
(276) 439-1461
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0206009050
VA
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009135022
—
VA
Enumeration date
06/06/2006
Last updated
09/22/2020
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