Healthcare Provider Details

I. General information

NPI: 1760406185
Provider Name (Legal Business Name): RUXTON HEALTH CARE V, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 08/22/2020
Certification Date:
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

Practice location:
  • Phone: 804-320-7901
  • Fax: 804-272-7129
Mailing address:
  • Phone: 804-320-7901
  • Fax: 804-272-7129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH2535
License Number StateVA

VIII. Authorized Official

Name: MR. EAMONN DENNIS REILLY
Title or Position: CEO
Credential:
Phone: 410-715-8900