Provider Demographics
NPI:1184009557
Name:VIRGINIA HEALTHCARE SERVICES OF FREDERICKSBURG
Entity Type:Organization
Organization Name:VIRGINIA HEALTHCARE SERVICES OF FREDERICKSBURG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DIRECTOR OF NURSING
Authorized Official - Prefix:MS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:S
Authorized Official - Last Name:COREY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:540-369-8322
Mailing Address - Street 1:2015 RESERVOIR ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-8739
Mailing Address - Country:US
Mailing Address - Phone:540-369-8322
Mailing Address - Fax:540-301-0751
Practice Address - Street 1:2015 RESERVOIR ST
Practice Address - Street 2:SUITE 204
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8739
Practice Address - Country:US
Practice Address - Phone:540-369-8322
Practice Address - Fax:540-301-0751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-27
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-11696251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA497669Medicare Oscar/Certification