Provider Demographics
NPI:1497721716
Name:COMMONWEALTH HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:COMMONWEALTH HOME HEALTH CARE, INC.
Other - Org Name:COMMONWEALTH HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNTS RECEIVABLE SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLENICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-797-2332
Mailing Address - Street 1:479 PINEY FOREST RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-4044
Mailing Address - Country:US
Mailing Address - Phone:434-797-2332
Mailing Address - Fax:434-799-4114
Practice Address - Street 1:479 PINEY FOREST RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-4044
Practice Address - Country:US
Practice Address - Phone:434-797-2332
Practice Address - Fax:434-797-9230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-27
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0206008455332BX2000X
NC00755332BX2000X
SC60-006105332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0481POtherBC/BS OF NORTH CAROLINA
VA017792OtherANTHEM TRIGON BC/BS
NC7700444Medicaid
VA9133607Medicaid
VA9133607Medicaid