Provider Demographics
NPI:1265738306
Name:SMB HOME HEALTHCARE
Entity type:Organization
Organization Name:SMB HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/ MED TECH
Authorized Official - Prefix:MRS
Authorized Official - First Name:MADGE
Authorized Official - Middle Name:F
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-589-0999
Mailing Address - Street 1:4713 THRESHER CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-6310
Mailing Address - Country:US
Mailing Address - Phone:757-589-0999
Mailing Address - Fax:757-473-3277
Practice Address - Street 1:4713 THRESHER CT
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-6310
Practice Address - Country:US
Practice Address - Phone:757-589-0999
Practice Address - Fax:757-473-3277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA201013072600008080251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA=========OtherPRIVATE COMPANIES
VA=========Medicaid
VA=========Medicaid
VA=========Medicare UPIN
VA=========Medicare PIN