Provider Demographics
NPI:1861698029
Name:MARVINA HOME HEALTH & HOSPICE
Entity type:Organization
Organization Name:MARVINA HOME HEALTH & HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JIDE
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-413-9095
Mailing Address - Street 1:1403 GREENBRIER PKWY STE 501
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2876
Mailing Address - Country:US
Mailing Address - Phone:757-413-9095
Mailing Address - Fax:757-413-2053
Practice Address - Street 1:1403 GREENBRIER PKWY STE 501
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2876
Practice Address - Country:US
Practice Address - Phone:757-413-9095
Practice Address - Fax:757-413-2053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHSP-07134251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA491589Medicare ID - Type UnspecifiedHOSPICE PROVIDER