Provider Demographics
NPI:1760928113
Name:ADORATION HOME HEALTH CARE VIRGINIA LLC
Entity Type:Organization
Organization Name:ADORATION HOME HEALTH CARE VIRGINIA LLC
Other - Org Name:ADORATION HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:S
Authorized Official - Last Name:PEMBERTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-272-3466
Mailing Address - Street 1:805 N WHITTINGTON PKWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-5186
Mailing Address - Country:US
Mailing Address - Phone:502-630-7425
Mailing Address - Fax:
Practice Address - Street 1:448 LAKESHORE PKWY STE 215
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-4264
Practice Address - Country:US
Practice Address - Phone:803-567-5970
Practice Address - Fax:877-242-3291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-10
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCHHA-0326OtherSC DHEC
SCHHA347Medicaid