Provider Demographics
NPI:1932476397
Name:PIONEER PERSONAL CARE , INC.
Entity Type:Organization
Organization Name:PIONEER PERSONAL CARE , INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:804-721-7742
Mailing Address - Street 1:PO BOX 1342
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-1342
Mailing Address - Country:US
Mailing Address - Phone:804-721-7742
Mailing Address - Fax:804-469-7745
Practice Address - Street 1:13915 BOYDTON PLANK RD
Practice Address - Street 2:
Practice Address - City:DINWIDDIE
Practice Address - State:VA
Practice Address - Zip Code:23841-2451
Practice Address - Country:US
Practice Address - Phone:804-469-4664
Practice Address - Fax:804-469-7745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0102107551Medicaid
VA0087005754Medicaid
VA0087709058Medicaid