Healthcare Provider Details

I. General information

NPI: 1083668982
Provider Name (Legal Business Name): SHORE HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 01/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9506 HOSPITAL AVE
NASSAWADOX VA
23413
US

IV. Provider business mailing address

PO BOX 803
NASSAWADOX VA
23413-0803
US

V. Phone/Fax

Practice location:
  • Phone: 757-414-8333
  • Fax: 757-414-8338
Mailing address:
  • Phone: 757-414-8333
  • Fax: 757-414-8338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH ZAGER
Title or Position: PRESIDENT CEO
Credential:
Phone: 757-414-8765