Healthcare Provider Details

I. General information

NPI: 1235163874
Provider Name (Legal Business Name): CHESAPEAKE HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 05/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HARRIS RD
KILMARNOCK VA
22482
US

IV. Provider business mailing address

8580 MAGELLAN PKWY
RICHMOND VA
23227-1149
US

V. Phone/Fax

Practice location:
  • Phone: 804-435-8000
  • Fax: 804-435-8543
Mailing address:
  • Phone: 804-627-5573
  • Fax: 866-449-0896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHAN F QUIRICONI JR.
Title or Position: CFO
Credential:
Phone: 804-281-8301