Provider Demographics
NPI:1073530846
Name:HASLUP ENTERPRISES, LTD.
Entity Type:Organization
Organization Name:HASLUP ENTERPRISES, LTD.
Other - Org Name:INTERIM HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:HASLUP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-295-5501
Mailing Address - Street 1:103 S PANTOPS DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8617
Mailing Address - Country:US
Mailing Address - Phone:434-295-5501
Mailing Address - Fax:434-295-4938
Practice Address - Street 1:516 S INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1153
Practice Address - Country:US
Practice Address - Phone:757-466-1401
Practice Address - Fax:757-466-8223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAMEDICARE CERTIFIED251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA497264Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER