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General NPI Number Information
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NPI Number | 1982326823
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Entity Type | Organization
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Legal Business Name | FORT NORFOLK RETIREMENT COMMUNITY
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Dates
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Enumeration Date | 09/16/2022
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Last Update Date | 09/16/2022
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Provider Practice Location Address
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Address Line | 1 COLLEY AVENUE
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City | NORFOLK
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State | VA
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Zip | 23510-1038
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Country | US
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Telephone | 757-616-7921
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Fax | 757-616-7955
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Provider Business Mailing Address
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Address Line | 1 COLLEY AVENUE
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City | NORFOLK
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State | VA
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Zip | 23510-1038
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Country | US
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Telephone | 757-616-7921
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Fax | 757-616-7955
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Authorized Official
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Title or Position | VICE PRESIDENT OF FINANCE/CONTROLLE
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Name | MR. HISHAM FAHIM
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Credential |
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Telephone | 757-616-7952
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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