Provider Demographics
NPI:1225061583
Name:SNYDER NURSING HOME
Entity Type:Organization
Organization Name:SNYDER NURSING HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:DENSON
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:540-389-6305
Mailing Address - Street 1:11 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-3735
Mailing Address - Country:US
Mailing Address - Phone:540-389-6305
Mailing Address - Fax:540-389-5376
Practice Address - Street 1:11 N BROAD ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-3735
Practice Address - Country:US
Practice Address - Phone:540-389-6305
Practice Address - Fax:540-389-5376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VANH2692313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4965914Medicaid