Provider Demographics
NPI:1851932206
Name:AMERIGROUP HOME HEALTH CARE, LLC.
Entity Type:Organization
Organization Name:AMERIGROUP HOME HEALTH CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SULTANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAYFATOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-603-3941
Mailing Address - Street 1:10067 SANDMEYER LN STE 312
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-3533
Mailing Address - Country:US
Mailing Address - Phone:773-603-3941
Mailing Address - Fax:
Practice Address - Street 1:10067 SANDMEYER LN STE 312
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-3533
Practice Address - Country:US
Practice Address - Phone:773-603-3941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health