Provider Demographics
NPI:1760465033
Name:STAMPER'S HEALTH ENTERPRISES, INC
Entity Type:Organization
Organization Name:STAMPER'S HEALTH ENTERPRISES, INC
Other - Org Name:VIRGINIA'S HOSPICE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:STAMPER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:276-686-6321
Mailing Address - Street 1:PO BOX 257
Mailing Address - Street 2:
Mailing Address - City:RURAL RETREAT
Mailing Address - State:VA
Mailing Address - Zip Code:24368-0257
Mailing Address - Country:US
Mailing Address - Phone:276-686-6321
Mailing Address - Fax:276-686-6160
Practice Address - Street 1:544 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RURAL RETREAT
Practice Address - State:VA
Practice Address - Zip Code:24368-3123
Practice Address - Country:US
Practice Address - Phone:276-686-6321
Practice Address - Fax:276-686-6160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-21
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0562-15251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004910516Medicaid
VA004910516Medicaid