Provider Demographics
NPI:1316541105
Name:LATASHA M VAMPER
Entity Type:Organization
Organization Name:LATASHA M VAMPER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VAMPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-728-7732
Mailing Address - Street 1:2025 SPRING GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:VA
Mailing Address - Zip Code:24531-5431
Mailing Address - Country:US
Mailing Address - Phone:434-728-3770
Mailing Address - Fax:
Practice Address - Street 1:13701 US HIGHWAY 29 STE 2
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:VA
Practice Address - Zip Code:24531-3612
Practice Address - Country:US
Practice Address - Phone:434-728-7732
Practice Address - Fax:866-621-2940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health