Healthcare Provider Details

I. General information

NPI: 1457375099
Provider Name (Legal Business Name): AUGUSTA FACILITY OPERATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 CROSS ROAD LN
FISHERSVILLE VA
22939-2331
US

IV. Provider business mailing address

83 CROSS ROAD LN
FISHERSVILLE VA
22939-2331
US

V. Phone/Fax

Practice location:
  • Phone: 540-885-8424
  • Fax: 540-885-8434
Mailing address:
  • Phone: 540-885-8424
  • Fax:

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: TIM LEHNER
Title or Position: MANAGER
Credential:
Phone: 770-698-9040