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General NPI Number Information
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NPI Number | 1972711398
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Entity Type | Organization
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Legal Business Name | FRIENDSHIP OUTPATIENT & WELLNESS SERVICES, INC.
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 391 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 | 540-265-2199
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Fax | 540-265-2242
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Provider Business Mailing Address
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Address Line | P.O. 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 | MIKE SHANNON
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Credential |
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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 | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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