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General NPI Number Information
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NPI Number | 1205655206
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Entity Type | Organization
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Legal Business Name | SOUTH HILL VA OPCO LLC
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 125 BUENA VISTA CIR
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City | SOUTH HILL
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State | VA
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Zip | 23970-1431
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Country | US
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Telephone | 434-447-3151
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Fax |
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Provider Business Mailing Address
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Address Line | 125 BUENA VISTA CIR
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City | SOUTH HILL
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State | VA
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Zip | 23970-1431
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | AKIVA SHAPIRO
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Credential |
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Telephone | 201-581-6622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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