Provider Demographics
NPI:1437378031
Name:HORIZON HEALTH SERVICES INC
Entity Type:Organization
Organization Name:HORIZON HEALTH SERVICES INC
Other - Org Name:IVOR MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:EBERSOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-859-6161
Mailing Address - Street 1:8575 IVOR ROAD
Mailing Address - Street 2:
Mailing Address - City:IVOR
Mailing Address - State:VA
Mailing Address - Zip Code:23866
Mailing Address - Country:US
Mailing Address - Phone:757-859-6161
Mailing Address - Fax:757-859-6452
Practice Address - Street 1:8575 IVOR ROAD
Practice Address - Street 2:
Practice Address - City:IVOR
Practice Address - State:VA
Practice Address - Zip Code:23866
Practice Address - Country:US
Practice Address - Phone:757-859-6161
Practice Address - Fax:757-859-6452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007695594Medicaid
VAC01681Medicare PIN