- Enrollment id
- O20070227000513
- Enrollment state
- VA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1962454769
- Multiple npi flag
- N
- Ccn
- 491579
- Associate id
- 3173431590
- Organization name
- MEDI HOME HEALTH AGENCY, INC.
- Doing business as name
- MEDI HOME HOSPICE
- Incorporation date
- 1996-01-11
- Incorporation state
- VA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 1430 ROLKIN CT
- Address line 2
- STE 203
- City
- CHARLOTTESVILLE
- State
- VA
- Zip code
- 229113582