Provider Demographics
NPI:1174237721
Name:NEXUS HOMECARE LLC
Entity type:Organization
Organization Name:NEXUS HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:MCKEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-314-4607
Mailing Address - Street 1:30 E CLAY ST STE 103
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-3779
Mailing Address - Country:US
Mailing Address - Phone:540-314-4607
Mailing Address - Fax:540-380-3127
Practice Address - Street 1:30 E CLAY ST STE 103
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-3779
Practice Address - Country:US
Practice Address - Phone:540-314-4607
Practice Address - Fax:540-380-3127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA3001748438Medicaid