Provider Demographics
NPI:1790739779
Name:RETREAT HOSPITAL, INC.
Entity Type:Organization
Organization Name:RETREAT HOSPITAL, INC.
Other - Org Name:RETREAT HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-254-5443
Mailing Address - Street 1:2621 GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-4308
Mailing Address - Country:US
Mailing Address - Phone:804-254-5100
Mailing Address - Fax:804-254-5187
Practice Address - Street 1:2621 GROVE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-4308
Practice Address - Country:US
Practice Address - Phone:804-254-5100
Practice Address - Fax:804-254-5187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01509984Medicaid
525293OtherNCPPO
VA100554OtherWELLPOINT
228721OtherALLIANCE
09043400030OtherQUALCHOICE
09043400030OtherQUALCHOICE