Provider Demographics
NPI:1700532918
Name:BENMAX HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:BENMAX HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NNKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-449-3300
Mailing Address - Street 1:11874 SUNRISE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-3323
Mailing Address - Country:US
Mailing Address - Phone:571-449-3300
Mailing Address - Fax:571-699-0540
Practice Address - Street 1:295 INDUSTRIAL DR STE D
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-2538
Practice Address - Country:US
Practice Address - Phone:571-449-3300
Practice Address - Fax:571-699-0540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health