Provider Demographics
NPI:1235297961
Name:VMT HOME HEALTH AGENCY
Entity Type:Organization
Organization Name:VMT HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:202-282-3104
Mailing Address - Street 1:4201 CONNECTICUT AVE NW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-1158
Mailing Address - Country:US
Mailing Address - Phone:202-282-3104
Mailing Address - Fax:202-282-3109
Practice Address - Street 1:4201 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 200
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-1158
Practice Address - Country:US
Practice Address - Phone:202-282-3104
Practice Address - Fax:202-282-3109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC026926300Medicaid