Provider Demographics
NPI:1760193403
Name:JWK INTERNATIONAL HOME HEALTHCARE INC
Entity Type:Organization
Organization Name:JWK INTERNATIONAL HOME HEALTHCARE INC
Other - Org Name:JWK INTERNATIONAL HOME HEALTHCARE INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:K
Authorized Official - Last Name:LUKWAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-547-7651
Mailing Address - Street 1:112 HAMLIN DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405-3371
Mailing Address - Country:US
Mailing Address - Phone:571-552-1899
Mailing Address - Fax:
Practice Address - Street 1:112 HAMLIN DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405-3371
Practice Address - Country:US
Practice Address - Phone:571-552-1899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-13
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1760193403Medicaid