Basic Information
Provider Information
NPI: 1629025911
EntityType: 2
ReplacementNPI:  
OrganizationName: TOTAL HOME HEALTH CARE, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: MEDICAL SERVICES OF AMERICA HOME HEALTH AND HOSPICE
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1928
Address2:  
City: LEXINGTON
State: SC
PostalCode: 290711928
CountryCode: US
TelephoneNumber: 8039570500
FaxNumber: 8883426190
Practice Location
Address1: 1935 FRONT ST
Address2:  
City: RICHLANDS
State: VA
PostalCode: 246412350
CountryCode: US
TelephoneNumber: 2769644202
FaxNumber: 2769644204
Other Information
ProviderEnumerationDate: 05/30/2006
LastUpdateDate: 06/25/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: JEFFCOAT
AuthorizedOfficialFirstName: CHRISTINA
AuthorizedOfficialMiddleName: M
AuthorizedOfficialTitleorPosition: VICE PRESIDENT
AuthorizedOfficialTelephone: 8039570500
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/25/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251G00000X  Y AgenciesHospice Care, Community Based 

ID Information
IDTypeStateIssuerDescription
491046005VA MEDICAID


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