Healthcare Provider Details
I. General information
NPI: 1619697976
Provider Name (Legal Business Name): SOUTHAMPTON OPERATOR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/29/2022
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7246 FOREST HILL AVE
RICHMOND VA
23225-1524
US
IV. Provider business mailing address
7246 FOREST HILL AVE
RICHMOND VA
23225-1524
US
V. Phone/Fax
- Phone: 804-320-7901
- Fax:
- Phone:
- Fax:
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:
MINDEE
POSEN
Title or Position: MEDICARE ADMINISTRATION OFFICER
Credential:
Phone: 845-825-2217