Provider Demographics
NPI:1417602749
Name:CHESAPEAKE HOSPITAL AUTHORITY
Entity Type:Organization
Organization Name:CHESAPEAKE HOSPITAL AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:MCDONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-312-3138
Mailing Address - Street 1:667 KINGSBOROUGH SQ STE 101
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4999
Mailing Address - Country:US
Mailing Address - Phone:757-312-4481
Mailing Address - Fax:
Practice Address - Street 1:100 PLANK BRIDGE ROAD
Practice Address - Street 2:STE B
Practice Address - City:CAMDEN
Practice Address - State:NC
Practice Address - Zip Code:27921
Practice Address - Country:US
Practice Address - Phone:252-331-1829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHESAPEAKE HOSPITAL AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health