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Organization
SHORE HEALTH SERVICES INC
Active
Organization
SHORE HEALTH SERVICES INC
Active
Other names
Shore Memorial Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT P YEARTY (CFO)
(757) 414-8756
Entity
Organization
Contact information
Practice address
9507 HOSPITAL AVE, NASSAWADOX, VA 23413
(757) 414-8702
(757) 414-8335
Mailing address
PO BOX 17, 9507 HOSPITAL AVE, NASSAWADOX, VA 23413
(757) 414-8702
(757) 414-8335
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
442205
ANTHEM
VA
05
—
4951638
—
VA
Enumeration date
11/09/2006
Last updated
07/21/2022
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