Healthcare Provider Details

I. General information

NPI: 1275041600
Provider Name (Legal Business Name): NORFOLK AREA SENIOR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2018
Last Update Date: 01/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 GEORGE WASHINGTON HWY N
CHESAPEAKE VA
23323-3505
US

IV. Provider business mailing address

24641 US HIGHWAY 19 N
CLEARWATER FL
33763-5007
US

V. Phone/Fax

Practice location:
  • Phone: 757-485-5000
  • Fax: 757-485-3414
Mailing address:
  • Phone: 727-499-5224
  • Fax: 727-499-5224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: TRINA FISK
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 727-499-5224