Provider Demographics
NPI:1376536839
Name:COMMONWEALTH HOME NURSING INC
Entity Type:Organization
Organization Name:COMMONWEALTH HOME NURSING INC
Other - Org Name:COMMONWEALTH HOME NURSING AND HOSPICE, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:R
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:434-792-4663
Mailing Address - Street 1:159 EXECUTIVE DR
Mailing Address - Street 2:SUITE H
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-4160
Mailing Address - Country:US
Mailing Address - Phone:434-792-4663
Mailing Address - Fax:434-793-7429
Practice Address - Street 1:159 EXECUTIVE DR
Practice Address - Street 2:SUITE H
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-4160
Practice Address - Country:US
Practice Address - Phone:434-792-4663
Practice Address - Fax:434-793-7429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-30
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006707OtherANTHEM BC/BS
VA71640OtherOPTIMA
VA004970691Medicaid
VA004970691Medicaid