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General NPI Number Information
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NPI Number | 1114975331
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Entity Type | Organization
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Legal Business Name | BEDFORD MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 03/25/2021
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Provider Practice Location Address
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Address Line | 1613 OAKWOOD ST
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City | BEDFORD
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State | VA
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Zip | 24523-1213
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Country | US
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Telephone | 540-224-5512
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Fax | 540-224-5507
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Provider Business Mailing Address
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Address Line | 213 S JEFFERSON ST
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City | ROANOKE
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State | VA
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Zip | 24011-1705
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Country | US
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Telephone | 540-224-5512
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Fax | 540-224-5507
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Authorized Official
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Title or Position | CFO
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Name | DOUG DAVENPORT
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Credential |
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Telephone | 434-200-4708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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