Provider Demographics
NPI:1245239540
Name:HOME CARE DELIVERED, INC.
Entity Type:Organization
Organization Name:HOME CARE DELIVERED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:L
Authorized Official - Last Name:FOX
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:800-565-6167
Mailing Address - Street 1:11013 W BROAD ST
Mailing Address - Street 2:FOURTH FLOOR
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-6017
Mailing Address - Country:US
Mailing Address - Phone:804-200-7300
Mailing Address - Fax:866-498-7627
Practice Address - Street 1:11013 W BROAD ST
Practice Address - Street 2:FOURTH FLOOR
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-6017
Practice Address - Country:US
Practice Address - Phone:800-565-6167
Practice Address - Fax:866-498-7627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0206008481332B00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009114041Medicaid
OH2528992Medicaid
DC035444200Medicaid
PA0019747970001Medicaid
MS06831832Medicaid
MD403623900Medicaid
TX171297801Medicaid
KS200311110AMedicaid
NE10025265600Medicaid