Healthcare Provider Details

I. General information

NPI: 1760580757
Provider Name (Legal Business Name): VCU HEALTH TAPPAHANNOCK HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 04/22/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 HOSPITAL RD
TAPPAHANNOCK VA
22560
US

IV. Provider business mailing address

PO BOX 783692
PHILADELPHIA PA
19178-3692
US

V. Phone/Fax

Practice location:
  • Phone: 804-443-3311
  • Fax: 804-443-6150
Mailing address:
  • Phone: 804-221-1067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License NumberH1889
License Number StateVA

VIII. Authorized Official

Name: ELIZABETH HARLAN
Title or Position: REVENUE CYCLE DIRECTOR
Credential:
Phone: 804-221-1067