Healthcare Provider Details

I. General information

NPI: 1083669832
Provider Name (Legal Business Name): NHC HEALTHCARE-BRISTOL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 06/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 NORTH ST
BRISTOL VA
24201-3274
US

IV. Provider business mailing address

245 NORTH ST
BRISTOL VA
24201-3274
US

V. Phone/Fax

Practice location:
  • Phone: 276-669-4711
  • Fax:
Mailing address:
  • Phone: 276-669-4711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH2639
License Number StateVA

VIII. Authorized Official

Name: HOWARD JAY NASON JR.
Title or Position: MANAGER OF LLC
Credential:
Phone: 865-690-9900