Organization
CENTRA POST ACUTE SERVICES LLC
Active
Parent organization
CENTRA HEALTH INC
Other names
Virginia Baptist Hospital Guggenheimer
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRA HEALTH INC
Authorized official
MR. LEWIS C ADDISON (SVP CFO)
(434) 200-4708
Entity
Organization
Contact information
Practice address
3300 RIVERMONT AVE, LYNCHBURG, VA 24503-2030
(434) 200-2161
(434) 200-6638
Mailing address
PO BOX 41000, LYNCHBURG, VA 24506-4100
(434) 200-2161
(434) 200-6638
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
H1911
VA
314000000X
Skilled Nursing Facility
Primary
H1911
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000344
ANTHEM
VA
05
—
004951123
—
VA
01
—
004960408
MEDICAID SPECIALIZED CARE
VA
Enumeration date
06/10/2014
Last updated
12/03/2014
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