Provider Demographics
NPI:1497566731
Name:SUPPORTIVE CARE AGENCY
Entity type:Organization
Organization Name:SUPPORTIVE CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EWURAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-485-5361
Mailing Address - Street 1:34 RAPIDAN DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-4653
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:34 RAPIDAN DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22556-4653
Practice Address - Country:US
Practice Address - Phone:703-485-5361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care