Provider Demographics
NPI:1578648143
Name:ESPRIT HOMECARE LLC
Entity Type:Organization
Organization Name:ESPRIT HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ZELALEM
Authorized Official - Middle Name:B
Authorized Official - Last Name:DAGNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-998-7400
Mailing Address - Street 1:750 MILLER DR SE
Mailing Address - Street 2:SUITE F1
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-8916
Mailing Address - Country:US
Mailing Address - Phone:703-777-3389
Mailing Address - Fax:
Practice Address - Street 1:750 MILLER DR SE
Practice Address - Street 2:SUITE F1
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-8916
Practice Address - Country:US
Practice Address - Phone:703-777-3389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0206008438332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA299610OtherAMERIGROUP
VA573366OtherAETNA
VA208902OtherANTHEM BCBS
VA009116389Medicaid
VA485019OtherNCPPO
VA208902OtherANTHEM BCBS