Organization
EDGEMONT CENTER, INC
Active
Other names
Edgemont Rehabilitation and Recovery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL A MURDOCH ADMINISTRATOR (ADMINISTRATOR/PRESIDENT OF COMPANY)
(276) 228-7380
Entity
Organization
Contact information
Practice address
100 EDGEMONT RD, WYTHEVILLE, VA 24382-4337
(276) 228-7380
(276) 228-6811
Mailing address
100 EDGEMONT RD, WYTHEVILLE, VA 24382-4337
(276) 228-7380
(276) 228-6811
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
NH2545
VA
314000000X
Skilled Nursing Facility
Primary
NH2545
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
265602
ANTHEM BLUE CROSS BLUE SH
VA
05
—
4951751
—
VA
Enumeration date
10/27/2005
Last updated
10/24/2011
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