Provider Demographics
NPI:1649663980
Name:DIRECT HOME HEALTH CARE INC
Entity type:Organization
Organization Name:DIRECT HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:FERNANDO
Authorized Official - Last Name:ILAPIT
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:757-405-6320
Mailing Address - Street 1:729 THIMBLE SHOALS BLVD
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4217
Mailing Address - Country:US
Mailing Address - Phone:757-405-6320
Mailing Address - Fax:757-673-5762
Practice Address - Street 1:729 THIMBLE SHOALS BLVD
Practice Address - Street 2:SUITE 3A
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4217
Practice Address - Country:US
Practice Address - Phone:757-405-6320
Practice Address - Fax:757-673-5762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO15760251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0153195695Medicaid
VA0153379661Medicaid