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NPI Code Detail

MEDICARE: HALIFAX REGIONAL HOSPITAL, INC.

MEDICARE: HALIFAX REGIONAL HOSPITAL, INC.
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
1251E00000XHome Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1001841OTHERVABCBS HOME HEALTH PROV
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972563872
Entity Type Code : Organization
Provider Name (Legal Business Name) : HALIFAX REGIONAL HOSPITAL, INC.
Provider Business Mailing Address
First Line : 2204 WILBORN AVE
Second Line :
City : SOUTH BOSTON
State : VA
Zip : 24592-1645
Country : US
Telephone Number : 434-517-3100
Fax Number : 434-575-6752
Provider Business Practice Location Address
First Line : 2204 WILBORN AVE
Second Line :
City : SOUTH BOSTON
State : VA
Zip : 24592-1645
Country : US
Telephone Number : 434-517-3100
Fax Number : 434-575-6752
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : THOMAS KLUGE
Credential :
Telephone Number : 434-517-3100
Provider Enumeration Date : 03/24/2006
Last Update Date : 02/05/2015

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Directions to “HALIFAX REGIONAL HOSPITAL, INC. ” Practice Location

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