Healthcare Provider Details

I. General information

NPI: 1568412831
Provider Name (Legal Business Name): RUXTON HEALTH CARE VI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 VIRGINIA AVE
ALEXANDRIA VA
22302-3200
US

IV. Provider business mailing address

900 VIRGINIA AVE
ALEXANDRIA VA
22302-3200
US

V. Phone/Fax

Practice location:
  • Phone: 703-684-9100
  • Fax: 703-684-6195
Mailing address:
  • Phone: 703-684-9100
  • Fax: 703-684-6195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH2595
License Number StateVA

VIII. Authorized Official

Name: MR. EAMONN REILLY
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 410-715-8900