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NPI Code Detail

MEDICARE: CHASE CITY HEALTH CARE LLC

MEDICARE: CHASE CITY HEALTH CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing FacilityNH2755VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1177195OTHERVAANTHEM/BLUE CROSS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285603142
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHASE CITY HEALTH CARE LLC
Provider Business Mailing Address
First Line : 5372 FALLOWATER LN
Second Line : SUITE 200
City : ROANOKE
State : VA
Zip : 24018-0907
Country : US
Telephone Number : 540-725-8910
Fax Number : 540-725-8914
Provider Business Practice Location Address
First Line : 5539 HIGHWAY 47
Second Line :
City : CHASE CITY
State : VA
Zip : 23924-3727
Country : US
Telephone Number : 434-372-8885
Fax Number : 434-372-8886
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : JOSEPH ANTHONY ALESANTRINO
Credential :
Telephone Number : 540-725-8910
Provider Enumeration Date : 03/14/2006
Last Update Date : 01/13/2021

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Directions to “CHASE CITY HEALTH CARE LLC ” Practice Location

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