Provider Demographics
NPI:1225365745
Name:HPR MEDICAL SERVICES
Entity Type:Organization
Organization Name:HPR MEDICAL SERVICES
Other - Org Name:HPR HOME HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:MCRAE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-201-6200
Mailing Address - Street 1:468 S INDEPENDENCE BLVD STE A102
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1158
Mailing Address - Country:US
Mailing Address - Phone:757-201-6200
Mailing Address - Fax:757-222-1794
Practice Address - Street 1:468 S INDEPENDENCE BLVD STE A102
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1158
Practice Address - Country:US
Practice Address - Phone:757-201-6200
Practice Address - Fax:757-222-1794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-10405253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1487885364Medicaid