Provider Demographics
NPI:1326364191
Name:FAMA HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:FAMA HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:THECLA
Authorized Official - Middle Name:AMIN
Authorized Official - Last Name:NKEMATEH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:703-372-1544
Mailing Address - Street 1:7217 LOCKPORT PL
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-1584
Mailing Address - Country:US
Mailing Address - Phone:703-372-1544
Mailing Address - Fax:703-372-1547
Practice Address - Street 1:7217 LOCKPORT PL
Practice Address - Street 2:SUITE 204
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-1584
Practice Address - Country:US
Practice Address - Phone:703-372-1544
Practice Address - Fax:703-372-1547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-10643251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health