Organization
1ST PROVIDENCE HEALTH CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMELIA KORKOR (OWNER)
(571) 334-0571
Entity
Organization
Contact information
Practice address
1549 OLD BRIDGE RD STE 208, WOODBRIDGE, VA 22192-2737
(571) 334-0571
Mailing address
1549 OLD BRIDGE RD STE 208, WOODBRIDGE, VA 22192-2737
(571) 334-0571
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
11/10/2023
Last updated
04/29/2024
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