Provider Demographics
NPI:1215352547
Name:PAMCO CARE LLC
Entity type:Organization
Organization Name:PAMCO CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA'
Authorized Official - Middle Name:B
Authorized Official - Last Name:LUCAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-257-7000
Mailing Address - Street 1:8905 YORKSHIRE LANE
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20111
Mailing Address - Country:US
Mailing Address - Phone:703-257-7000
Mailing Address - Fax:703-257-7002
Practice Address - Street 1:7316 RESPITE COURT
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155
Practice Address - Country:US
Practice Address - Phone:703-257-7000
Practice Address - Fax:703-257-7002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA242225251S00000X
314000000X
VA2214314000000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility