# SHORE HEALTH SVC INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SHORE MEMORIAL HOSPITAL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861403990
- **Authorized official:** JAMES DAVIS (DIRCTR)
- **Authorized official phone:** (757) 414-8667

## Contact information

- **Practice address:** 9507 HOSPITAL AVE, NASSAWADOX, VA 23413
- **Practice address phone:** (757) 414-8781
- **Practice address fax:** (757) 442-6295
- **Mailing address:** 9507 HOSPITAL AVE, NASSAWADOX, VA 23413
- **Mailing address phone:** (757) 414-8781
- **Mailing address fax:** (757) 442-6295

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | 0201001224 | VA | Yes |

## Other

- **Enumeration date:** 08/11/2006
- **Last updated:** 04/21/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2103118 | PK | — |
| 05 | — | 4900375 | — | VA |