Provider Demographics
NPI:1245232412
Name:MARVINA HEALTH CARE SERVICES, INC
Entity Type:Organization
Organization Name:MARVINA HEALTH CARE SERVICES, INC
Other - Org Name:MARVINA HOME HEALTH & HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OLAJIDE
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-413-9095
Mailing Address - Street 1:1403 GREENBRIER PKWY
Mailing Address - Street 2:STE 501
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-0614
Mailing Address - Country:US
Mailing Address - Phone:757-413-9095
Mailing Address - Fax:757-413-2053
Practice Address - Street 1:1403 GREENBRIER PKWY
Practice Address - Street 2:STE 501
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-0614
Practice Address - Country:US
Practice Address - Phone:757-413-9095
Practice Address - Fax:757-413-2053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA497561251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA442226OtherANTHEM BCBS
VA442227OtherANTHEM BCBS
VA497561Medicare ID - Type Unspecified