Provider Demographics
NPI:1972737518
Name:TAMAR HEALTH CARE LLC
Entity Type:Organization
Organization Name:TAMAR HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARITY
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:757-831-2968
Mailing Address - Street 1:801 BUTLER ST
Mailing Address - Street 2:SUITE 20
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-3404
Mailing Address - Country:US
Mailing Address - Phone:757-831-2968
Mailing Address - Fax:757-436-5410
Practice Address - Street 1:801 BUTLER ST
Practice Address - Street 2:SUITE 20
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-3404
Practice Address - Country:US
Practice Address - Phone:757-831-2968
Practice Address - Fax:757-436-5410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0158560760Medicaid
VAHCO012777OtherVIRGINIA DEPARTMENT OF HEALTH