# THE WOODLAND INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southside Community Nursing Home Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497751879
- **Authorized official:** MR. GREGORY C COLE (PRESIDENT CEO)
- **Authorized official phone:** (434) 392-6106

## Contact information

- **Practice address:** 2003 COBB ST, FARMVILLE, VA 23901-2603
- **Practice address phone:** (434) 392-6106
- **Practice address fax:** (434) 392-4736
- **Mailing address:** 2003 COBB ST, FARMVILLE, VA 23901-2603
- **Mailing address phone:** (434) 392-6106
- **Mailing address fax:** (434) 392-4736

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH2590 | VA | Yes |

## Other

- **Enumeration date:** 06/22/2005
- **Last updated:** 03/20/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000238527 | ANTHEM OUTPATIENT | VA |
| 01 | — | 215748 | ANTHEM PROVIDER NUMBER | VA |
| 05 | — | 4953398 | — | VA |