MEDICARE: HOPEWELL OPERATOR 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
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1437790730
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPEWELL OPERATOR LLC

Provider Business Mailing Address
First Line	:	905 COUSINS AVE
Second Line	:
City	:	HOPEWELL
State	:	VA
Zip	:	23860-6507
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	905 COUSINS AVE
Second Line	:
City	:	HOPEWELL
State	:	VA
Zip	:	23860-6507
Country	:	US
Telephone Number	:	804-458-6325
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	ELAZAR FISCHER
Credential	:
Telephone Number	:	804-458-6325

Provider Enumeration Date	:	10/08/2019
Last Update Date	:	01/09/2020

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Directions to “HOPEWELL OPERATOR LLC ” Practice Location

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