Provider Demographics
NPI:1073997953
Name:JAMARRS HANDS
Entity Type:Organization
Organization Name:JAMARRS HANDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SERVICE FACILATOR
Authorized Official - Prefix:
Authorized Official - First Name:DORTHEA
Authorized Official - Middle Name:MORNET
Authorized Official - Last Name:KIRBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-252-1043
Mailing Address - Street 1:3090 BASSETT HGHTS RD
Mailing Address - Street 2:
Mailing Address - City:BASSETT
Mailing Address - State:VA
Mailing Address - Zip Code:24055-4815
Mailing Address - Country:US
Mailing Address - Phone:276-252-1043
Mailing Address - Fax:276-421-2300
Practice Address - Street 1:3090 BASSETT HEIGHTS ROAD EXT
Practice Address - Street 2:
Practice Address - City:BASSETT
Practice Address - State:VA
Practice Address - Zip Code:24055-4812
Practice Address - Country:US
Practice Address - Phone:276-252-1043
Practice Address - Fax:276-421-2300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-10
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA45-0674833302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization