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General NPI Number Information
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NPI Number | 1457597874
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Entity Type | Organization
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Legal Business Name | MEDICAL FACILITIES OF AMERICA LXXVI 76 LIMITED PARTNERSHIP
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Dates
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Enumeration Date | 01/07/2009
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Last Update Date | 02/24/2009
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Provider Practice Location Address
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Address Line | 505 WEST RIO RD
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-1411
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Country | US
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Telephone | 434-978-7015
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Fax |
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Provider Business Mailing Address
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Address Line | 2917 PENN FOREST BLVD
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City | ROANOKE
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State | VA
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Zip | 24018-4374
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Country | US
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Telephone | 540-989-3618
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Fax | 540-774-9443
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Authorized Official
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Title or Position | CFO, MFA, INC. GENERAL PARTNER
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Name | MR. CLAUDE NOVEL MARTIN III
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Credential |
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Telephone | 540-776-7526
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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 | NH2572
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License Number State | VA
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