Organization
THE WOODLAND INC
Active
Other names
Southside Community Nursing Home Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY C COLE (PRESIDENT CEO)
(434) 392-6106
Entity
Organization
Contact information
Practice address
2003 COBB ST, FARMVILLE, VA 23901-2603
(434) 392-6106
(434) 392-4736
Mailing address
2003 COBB ST, FARMVILLE, VA 23901-2603
(434) 392-6106
(434) 392-4736
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH2590
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000238527
ANTHEM OUTPATIENT
VA
01
—
215748
ANTHEM PROVIDER NUMBER
VA
05
—
4953398
—
VA
Enumeration date
06/22/2005
Last updated
03/20/2009
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