Provider Demographics
NPI:1598370306
Name:PELULLO HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:PELULLO HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:GUY
Authorized Official - Last Name:PELULLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-272-8838
Mailing Address - Street 1:4893 PRINCE WILLIAM PKWY STE 202
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-5404
Mailing Address - Country:US
Mailing Address - Phone:703-272-8838
Mailing Address - Fax:
Practice Address - Street 1:4893 PRINCE WILLIAM PKWY STE 202
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-5404
Practice Address - Country:US
Practice Address - Phone:703-272-8838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health