Organization
OLD DOMINION HOME CARE,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH RAYMOND AUGST III (PRESIDENT)
(703) 273-0422
Entity
Organization
Contact information
Practice address
10366 DEMOCRACY LN STE C, FAIRFAX, VA 22030-2530
(703) 273-0422
(703) 273-0423
Mailing address
10366 DEMOCRACY LN STE C, FAIRFAX, VA 22030-2530
(703) 273-0422
(703) 273-0423
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HCO-09523
VA
Other
Enumeration date
01/09/2009
Last updated
01/09/2009
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