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NPI Code Detail

MEDICARE: BETH SHOLOM HOME OF VIRGINIA

MEDICARE: BETH SHOLOM HOME OF VIRGINIA
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 FacilityNH2503VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1216278OTHERVAANTHEM PROVIDER #
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548292170
Entity Type Code : Organization
Provider Name (Legal Business Name) : BETH SHOLOM HOME OF VIRGINIA
Provider Business Mailing Address
First Line : PO BOX 29331
Second Line :
City : RICHMOND
State : VA
Zip : 23242-0331
Country : US
Telephone Number : 804-750-2183
Fax Number : 804-750-1078
Provider Business Practice Location Address
First Line : 1600 JOHN ROLFE PKWY
Second Line :
City : RICHMOND
State : VA
Zip : 23238-8110
Country : US
Telephone Number : 804-750-2183
Fax Number : 804-750-1078
Authorized Official
Title or Position : CFO
Name : MR. JOHN VINCENT BELLOTTI JR.
Credential :
Telephone Number : 804-421-5352
Provider Enumeration Date : 07/06/2006
Last Update Date : 05/12/2008

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Directions to “BETH SHOLOM HOME OF VIRGINIA ” Practice Location

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