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General NPI Number Information
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NPI Number | 1992724033
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Entity Type | Organization
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Legal Business Name | HALIFAX REGIONAL HOSPITAL
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 04/09/2015
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Provider Practice Location Address
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Address Line | 2204 WILBORN AVE
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City | SOUTH BOSTON
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State | VA
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Zip | 24592-1645
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Country | US
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Telephone | 434-517-3100
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Fax | 434-575-0377
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Provider Business Mailing Address
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Address Line | 2204 WILBORN AVE
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City | SOUTH BOSTON
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State | VA
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Zip | 24592-1645
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Country | US
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Telephone | 434-517-3100
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Fax | 434-575-0377
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Authorized Official
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Title or Position | COORDINATOR THIRD PARTY PAYERS
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Name | MRS. STEPHANIE W ELLIOTT
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Credential |
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Telephone | 434-517-3156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246Q00000X
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Taxonomy Name | Pathology Specialist/Technologist
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License Number | H1853
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 246W00000X
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Taxonomy Name | Cardiology Technician
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License Number | H1853
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | H1853
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License Number State | VA
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