Provider Demographics
NPI:1396072211
Name:HPR MEDICAL SERVICES
Entity type:Organization
Organization Name:HPR MEDICAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/HEALTH ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:MCCRAE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:7557-201-6200
Mailing Address - Street 1:468 S. INDEPENDENCE BLVD
Mailing Address - Street 2:SUITE 102A
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1105
Mailing Address - Country:US
Mailing Address - Phone:757-201-6200
Mailing Address - Fax:757-222-1794
Practice Address - Street 1:468 S. INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 102A
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1105
Practice Address - Country:US
Practice Address - Phone:757-201-6200
Practice Address - Fax:757-222-1794
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HPR MEDICAL SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-13
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHC010405253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care