Provider Demographics
NPI:1043874282
Name:AGATHA HOME HEALTH
Entity Type:Organization
Organization Name:AGATHA HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-427-7893
Mailing Address - Street 1:2950 FERN HILL PL
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4008
Mailing Address - Country:US
Mailing Address - Phone:240-427-7893
Mailing Address - Fax:301-645-1121
Practice Address - Street 1:2950 FERN HILL PL
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4008
Practice Address - Country:US
Practice Address - Phone:240-427-7893
Practice Address - Fax:301-645-1121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-23
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health