Healthcare Provider Details

I. General information

NPI: 1821097064
Provider Name (Legal Business Name): WESTPORT OPERATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 08/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 FOREST AVENUE
RICHMOND VA
23226
US

IV. Provider business mailing address

7300 FOREST AVENUE
RICHMOND VA
23226
US

V. Phone/Fax

Practice location:
  • Phone: 203-226-4201
  • Fax: 203-221-4766
Mailing address:
  • Phone: 203-226-4201
  • Fax: 203-221-4766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. A. ALBERTO LUGO
Title or Position: EXECUTIVE VP & GENERAL COUNSEL
Credential:
Phone: 201-242-4000