Provider Demographics
NPI:1639742109
Name:AMAZING HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:AMAZING HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:FROST
Authorized Official - Suffix:
Authorized Official - Credentials:MS DEGREE
Authorized Official - Phone:757-660-7119
Mailing Address - Street 1:716 THIMBLE SHOALS BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4545
Mailing Address - Country:US
Mailing Address - Phone:757-240-4444
Mailing Address - Fax:757-578-8478
Practice Address - Street 1:716 THIMBLE SHOALS BLVD
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4545
Practice Address - Country:US
Practice Address - Phone:757-240-4444
Practice Address - Fax:757-578-8478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1790956688Medicaid