Healthcare Provider Details

I. General information

NPI: 1386057420
Provider Name (Legal Business Name): BEDFORD POST ACUTE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2014
Last Update Date: 06/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1613 OAKWOOD ST
BEDFORD VA
24523-1213
US

IV. Provider business mailing address

1920 ATHERHOLT RD
LYNCHBURG VA
24501-1104
US

V. Phone/Fax

Practice location:
  • Phone: 434-200-2161
  • Fax: 434-200-6638
Mailing address:
  • Phone: 434-200-2161
  • Fax: 434-200-6638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberH 1828
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberH 1828
License Number StateVA

VIII. Authorized Official

Name: MR. LEWIS C ADDISON
Title or Position: SVP CFO
Credential:
Phone: 434-200-4708