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NPI Code Detail

MEDICARE: PCH OPERATIONS, LLC DBA R.J. REYNOLDS-PATRICK COUNTY MEMORIAL HOSPITAL

MEDICARE: PCH OPERATIONS, LLC DBA R.J. REYNOLDS-PATRICK COUNTY MEMORIAL HOSPITAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing FacilityH1919VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1171871OTHERVABLUE CROSS
2330049OTHERVAMAMSI

General Provider Information

NPI Number : 1700818994
Entity Type Code : Organization
Provider Name (Legal Business Name) : PCH OPERATIONS, LLC DBA R.J. REYNOLDS-PATRICK COUNTY MEMORIAL HOSPITAL
Provider Business Mailing Address
First Line : 18688 JEB STUART HWY
Second Line :
City : STUART
State : VA
Zip : 24171-1559
Country : US
Telephone Number : 276-694-8678
Fax Number : 276-694-8655
Provider Business Practice Location Address
First Line : 18688 JEB STUART HWY
Second Line :
City : STUART
State : VA
Zip : 24171-1559
Country : US
Telephone Number : 276-694-8678
Fax Number : 276-694-8655
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. JANICE F. WILKINS
Credential :
Telephone Number : 276-694-8678
Provider Enumeration Date : 07/07/2006
Last Update Date : 04/20/2008

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Practice Phone: 276-694-3151
Practice Fax: 276-694-8655

Directions to “PCH OPERATIONS, LLC DBA R.J. REYNOLDS-PATRICK COUNTY MEMORIAL HOSPITAL ” Practice Location

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