Provider Demographics
NPI:1649087164
Name:DELMARVA HOME HEALTH AGENCY LLC
Entity type:Organization
Organization Name:DELMARVA HOME HEALTH AGENCY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIETTA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:443-978-0425
Mailing Address - Street 1:807 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:POCOMOKE CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21851-1621
Mailing Address - Country:US
Mailing Address - Phone:443-978-0425
Mailing Address - Fax:
Practice Address - Street 1:807 WALNUT ST
Practice Address - Street 2:
Practice Address - City:POCOMOKE CITY
Practice Address - State:MD
Practice Address - Zip Code:21851-1621
Practice Address - Country:US
Practice Address - Phone:443-978-0425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-17
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDJW2ZHFXF8V39OtherUEI (UNIQUE ENTITY IDENTIFICATION)
MD1649087164OtherNPI-2