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General NPI Number Information
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NPI Number | 1417954140
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Entity Type | Organization
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Legal Business Name | FRIENDSHIP HEALTH AND REHAB CENTER, INC.
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 12/29/2014
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Provider Practice Location Address
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Address Line | 327 HERSHBERGER RD
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City | ROANOKE
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State | VA
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Zip | 24012-1983
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Country | US
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Telephone | 540-265-2100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7577
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City | ROANOKE
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State | VA
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Zip | 24019-0577
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Country | US
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Telephone | 540-265-2185
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Fax | 540-265-2051
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Authorized Official
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Title or Position | CFO
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Name | MR. C. MIKE SHANNON
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Credential | CPA
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Telephone | 540-777-4044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | NH2558
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License Number State | VA
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