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NPI Code Detail

MEDICARE: ENVOY OF FOREST HILLS, LLC

MEDICARE: ENVOY OF FOREST HILLS, 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 FacilityNH2535VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952554081
Entity Type Code : Organization
Provider Name (Legal Business Name) : ENVOY OF FOREST HILLS, LLC
Provider Business Mailing Address
First Line : 7246 FOREST HILL AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23225-1524
Country : US
Telephone Number : 804-320-7901
Fax Number : 804-272-7129
Provider Business Practice Location Address
First Line : 7246 FOREST HILL AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23225-1524
Country : US
Telephone Number : 804-320-7901
Fax Number : 804-272-7129
Authorized Official
Title or Position : VICE PRESIDENT
Name : KENNETH USSERY
Credential :
Telephone Number : 407-571-1550
Provider Enumeration Date : 11/03/2008
Last Update Date : 11/27/2023

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1184019481 — SUPRAJA ANGARU
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Practice Fax:
1306356571 — MARY KATHERINE DALY
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23225-1524
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1992216832 — MR. MICHAEL JAMES RAVEN LPTA
Practice Location Address:
7246 FOREST HILL AVE
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Practice Fax:

Directions to “ENVOY OF FOREST HILLS, LLC ” Practice Location

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