Healthcare Provider Details

I. General information

NPI: 1417954140
Provider Name (Legal Business Name): FRIENDSHIP HEALTH AND REHAB CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 HERSHBERGER RD
ROANOKE VA
24012-1983
US

IV. Provider business mailing address

PO BOX 7577
ROANOKE VA
24019-0577
US

V. Phone/Fax

Practice location:
  • Phone: 540-265-2100
  • Fax:
Mailing address:
  • Phone: 540-265-2185
  • Fax: 540-265-2051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH2558
License Number StateVA

VIII. Authorized Official

Name: CHARLES MICHAEL SHANNON
Title or Position: CFO
Credential:
Phone: 540-777-4044