Provider Demographics
NPI:1962680579
Name:DIRECT HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:DIRECT HOME HEALTH CARE, INC.
Other - Org Name:DIRECT HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:F
Authorized Official - Last Name:ILAPIT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:757-405-6320
Mailing Address - Street 1:729 THIMBLE SHOALS BLVD
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4217
Mailing Address - Country:US
Mailing Address - Phone:757-223-1211
Mailing Address - Fax:757-223-1477
Practice Address - Street 1:3100 LONDON BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23707-3402
Practice Address - Country:US
Practice Address - Phone:757-405-6320
Practice Address - Fax:757-405-6326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO O8155332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0153195695Medicaid
VA0087008774Medicaid
VA0087704687Medicaid
VA1285722371Medicaid