Healthcare Provider Details
I. General information
NPI: 1912153164
Provider Name (Legal Business Name): FREDERICKSBURG HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/07/2008
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6106 HEALTH CENTER LN
FREDERICKSBURG VA
22407-6687
US
IV. Provider business mailing address
5372 FALLOWATER LN SUITE 200
ROANOKE VA
24018-0907
US
V. Phone/Fax
- Phone: 540-785-1120
- Fax: 540-785-1105
- Phone: 540-725-8910
- Fax: 540-725-8914
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSEPH
ANTHONY
ALESANTRINO
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 540-725-8910