Provider Demographics
NPI:1528405768
Name:HANDS 4 HOME DIALYSIS
Entity Type:Organization
Organization Name:HANDS 4 HOME DIALYSIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROOKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-239-4443
Mailing Address - Street 1:147 MILL RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-4341
Mailing Address - Country:US
Mailing Address - Phone:434-609-4443
Mailing Address - Fax:
Practice Address - Street 1:147 MILL RIDGE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-4341
Practice Address - Country:US
Practice Address - Phone:434-239-4443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
A4OtherA4