Healthcare Provider Details

I. General information

NPI: 1194737437
Provider Name (Legal Business Name): MEDICAL FACILITIES OF AMERICA VI & XIII
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 05/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 CAMELOT DR
VIRGINIA BEACH VA
23454-2401
US

IV. Provider business mailing address

2917 PENN FOREST BLVD
ROANOKE VA
24018-4374
US

V. Phone/Fax

Practice location:
  • Phone: 757-481-3500
  • Fax: 757-481-4860
Mailing address:
  • Phone: 540-989-3618
  • Fax: 540-774-9443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH2709
License Number StateVA

VIII. Authorized Official

Name: MR. CLAUDE NOVEL MARTIN III
Title or Position: CFO, MFA INC. GENERAL PARTNER
Credential:
Phone: 540-776-7526