Provider Demographics
NPI:1619399748
Name:EL VRAJ CORPORATION
Entity Type:Organization
Organization Name:EL VRAJ CORPORATION
Other - Org Name:COMMONWEALTH FIRST HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-912-9368
Mailing Address - Street 1:968 S ORIOLE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-6206
Mailing Address - Country:US
Mailing Address - Phone:757-366-0708
Mailing Address - Fax:757-366-0709
Practice Address - Street 1:968 S ORIOLE DR STE 101
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-6206
Practice Address - Country:US
Practice Address - Phone:757-366-0708
Practice Address - Fax:757-366-0709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-08
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-14893251E00000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA47-4922555Medicaid