Provider Demographics
NPI:1053507384
Name:BESTWAY HEALTH CARE, LLC
Entity Type:Organization
Organization Name:BESTWAY HEALTH CARE, LLC
Other - Org Name:BESTWAY HEALTH CARE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:O
Authorized Official - Last Name:ETUTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-340-2361
Mailing Address - Street 1:3707 VIRGINIA BEACH BLVD
Mailing Address - Street 2:SUITE 218
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-3412
Mailing Address - Country:US
Mailing Address - Phone:757-340-2361
Mailing Address - Fax:757-340-7200
Practice Address - Street 1:3707 VIRGINIA BEACH BLVD
Practice Address - Street 2:SUITE 218
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-3412
Practice Address - Country:US
Practice Address - Phone:757-340-2361
Practice Address - Fax:757-340-7200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA03-210251E00000X
302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No302R00000XManaged Care OrganizationsHealth Maintenance Organization