Organization
SOUTHWEST HOME CARELLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMANDA SUE GARRETT NONE (CHIEF ADMINISTRATOR)
(276) 565-1703
Entity
Organization
Contact information
Practice address
503 W MAIN ST, APPALACHIA, VA 24216-1723
(276) 565-1703
Mailing address
503 WEST MAIN ST., APPALCHIA, VA 24216
(276) 565-1703
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0151693899
—
VA
05
—
0151694434
—
VA
Enumeration date
03/17/2008
Last updated
03/17/2008
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