Healthcare Provider Details

I. General information

NPI: 1073001079
Provider Name (Legal Business Name): CURIS AT ROANOKE OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2018
Last Update Date: 06/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 KING GEORGE AVE SW
ROANOKE VA
24016
US

IV. Provider business mailing address

324 KING GEORGE AVE SW
ROANOKE VA
24016-5213
US

V. Phone/Fax

Practice location:
  • Phone: 540-345-8139
  • Fax: 540-345-6421
Mailing address:
  • Phone: 540-345-8139
  • Fax: 540-345-6421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH2491
License Number StateVA

VIII. Authorized Official

Name: BENT PHILIPSON
Title or Position: MANAGER
Credential:
Phone: 516-869-3700