Provider Demographics
NPI:1235104514
Name:AUGUSTA HEALTH CARE, INC
Entity Type:Organization
Organization Name:AUGUSTA HEALTH CARE, INC
Other - Org Name:CARE HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:MEADOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-932-4000
Mailing Address - Street 1:PO BOX 215
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0215
Mailing Address - Country:US
Mailing Address - Phone:540-932-5162
Mailing Address - Fax:540-332-5875
Practice Address - Street 1:64 SPORTS MEDICINE DR
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939
Practice Address - Country:US
Practice Address - Phone:540-932-4955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AUGUSTA HEALTH CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-21
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA67712OtherANTHEM
VA9136525Medicaid
VA411390OtherBLACK LUNG
VA0153780001Medicare NSC