Provider Demographics
NPI:1689158115
Name:BEDFORD HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:BEDFORD HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:703-420-2712
Mailing Address - Street 1:7900 SUDLEY RD STE 424
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-2886
Mailing Address - Country:US
Mailing Address - Phone:703-713-2622
Mailing Address - Fax:703-420-2716
Practice Address - Street 1:7900 SUDLEY RD STE 424
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-2886
Practice Address - Country:US
Practice Address - Phone:703-713-2622
Practice Address - Fax:703-420-2716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health