Provider Demographics
NPI:1659411981
Name:HOME & HEART HEALTH INC
Entity Type:Organization
Organization Name:HOME & HEART HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAYE
Authorized Official - Middle Name:D
Authorized Official - Last Name:PEGELOW
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:540-899-3666
Mailing Address - Street 1:701 KENMORE AVE
Mailing Address - Street 2:SUITE 101A
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-5737
Mailing Address - Country:US
Mailing Address - Phone:540-899-3666
Mailing Address - Fax:540-899-3077
Practice Address - Street 1:701 KENMORE AVE
Practice Address - Street 2:SUITE 101A
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5737
Practice Address - Country:US
Practice Address - Phone:540-899-3666
Practice Address - Fax:540-899-3077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA114412OtherBCBS - ANTHEM
VA49-7422-1Medicaid
VA49-7422-1Medicaid