Provider Demographics
NPI:1588668842
Name:HALIFAX REGIONAL HOSPITAL, INC.
Entity Type:Organization
Organization Name:HALIFAX REGIONAL HOSPITAL, INC.
Other - Org Name:SENTARA HALIFAX REGIONAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LUMSDEN
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:434-517-3100
Mailing Address - Street 1:2204 WILBORN AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:VA
Mailing Address - Zip Code:24592-1645
Mailing Address - Country:US
Mailing Address - Phone:434-517-3100
Mailing Address - Fax:434-517-3819
Practice Address - Street 1:2204 WILBORN AVE
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:VA
Practice Address - Zip Code:24592-1645
Practice Address - Country:US
Practice Address - Phone:434-517-3100
Practice Address - Fax:434-575-0377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-02
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAH1853282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004900138Medicaid
VA490013Medicare Oscar/Certification