Healthcare Provider Details

I. General information

NPI: 1538191721
Provider Name (Legal Business Name): PCH OPERATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 12/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18688 JEB STUART HWY
STUART VA
24171-1559
US

IV. Provider business mailing address

18688 JEB STUART HWY
STUART VA
24171-1559
US

V. Phone/Fax

Practice location:
  • Phone: 276-694-8678
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License NumberH1919
License Number StateVA

VIII. Authorized Official

Name: MRS. JANICE F WILKINS
Title or Position: ADMINISTRATOR
Credential:
Phone: 276-694-8678