Organization
SHORE HEALTH SERVICES INC.
Active
Other names
Riverside Shore Memorial Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALTER W AUSTIN JR. (CFO)
(757) 875-7545
Entity
Organization
Contact information
Practice address
20480 MARKET ST, ONANCOCK, VA 23417
(757) 302-2100
Mailing address
608 DENBIGH BLVD STE 800, NEWPORT NEWS, VA 23608-4487
(757) 875-7545
(757) 875-7553
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
H1901
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000000040
ANTHEM
VA
05
—
004900375
—
VA
01
—
004951638
DMAS-SKILLED
VA
01
—
490037
MEDICARE ACUTE CARE
VA
Enumeration date
09/22/2006
Last updated
05/04/2021
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