Provider Demographics
NPI:1689086563
Name:ACCUMEDS HOME CARE LLC
Entity Type:Organization
Organization Name:ACCUMEDS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SERGENTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-371-1344
Mailing Address - Street 1:10560 MAIN ST
Mailing Address - Street 2:SUITE 112
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-7182
Mailing Address - Country:US
Mailing Address - Phone:703-371-1344
Mailing Address - Fax:
Practice Address - Street 1:10560 MAIN ST
Practice Address - Street 2:SUITE 112
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7182
Practice Address - Country:US
Practice Address - Phone:703-371-1344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC2100XNursing Service ProvidersRegistered NurseContinence CareGroup - Multi-Specialty