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COMMONWEALTH OF VIRGINIA HIRAM W DAVIS MEDICAL CENTER

Intermediate Care Facility, Mental Illness

Petersburg, Virginia

Provider NPI: 1447362660

Organization Information:
Organization Name:  COMMONWEALTH OF VIRGINIA HIRAM W DAVIS MEDICAL CENTER


Practice Location:
ALBEMARLE AND 7TH STREETS BUILDING 110 PETERSBURG, VA 23803 US
Tel: 804-524-7344  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y310500000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mental Illness
VA

Other Provider Identifiers:

IssuerNumberStateType
4967615VA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




INTERMEDIATE CARE JOBS VA - Page 1



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