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General NPI Number Information
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NPI Number | 1689616351
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Entity Type | Organization
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Legal Business Name | HEALTHLINK OF VIRGINIA SHORES, LLC
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 11/20/2012
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Provider Practice Location Address
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Address Line | 340 LYNN SHORES DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-2416
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Country | US
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Telephone | 757-340-6611
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Fax | 757-463-4147
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Provider Business Mailing Address
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Address Line | 340 LYNN SHORES DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-2416
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Country | US
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Telephone | 757-340-6611
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Fax | 757-463-4147
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. THOMAS D JOHNSON
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Credential |
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Telephone | 423-478-5953
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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 | NH2616
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License Number State | VA
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