Provider Demographics
NPI:1407993835
Name:AUGUSTA HEALTH CARE, INC.
Entity Type:Organization
Organization Name:AUGUSTA HEALTH CARE, INC.
Other - Org Name:CARE NURSING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:MEADOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-932-4000
Mailing Address - Street 1:64 SPORTS MEDICINE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939
Mailing Address - Country:US
Mailing Address - Phone:540-932-4942
Mailing Address - Fax:540-932-4616
Practice Address - Street 1:64 SPORTS MEDICINE CIRCLE
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939
Practice Address - Country:US
Practice Address - Phone:540-932-4942
Practice Address - Fax:540-932-4616
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AUGUSTA HEALTH CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-01
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA038694OtherANTHEM