Provider Demographics
NPI:1235608050
Name:ON TRACK HEALTHCARE LLC
Entity Type:Organization
Organization Name:ON TRACK HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:FRANCENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCORORY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-593-3299
Mailing Address - Street 1:1020 LECKIE ST STE 203
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23704-1904
Mailing Address - Country:US
Mailing Address - Phone:757-593-3299
Mailing Address - Fax:
Practice Address - Street 1:1020 LECKIE ST STE 203
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-1904
Practice Address - Country:US
Practice Address - Phone:757-593-3299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-21
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health