Organization
PATRICK HENRY HOSPITAL, INC.
Active
Other names
Riverside Adult Daycare, Williamsburg
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALTER W AUSTIN (SENIOR VP, LTC)
(757) 875-7846
Entity
Organization
Contact information
Practice address
3435 JOHN TYLER HWY, BUILDING 2, SUITE A, WILLIAMSBURG, VA 23185-1457
(757) 565-5305
(757) 875-2070
Mailing address
608 DENBIGH BLVD, SUITE 600, NEWPORT NEWS, VA 23608-4410
(757) 875-2023
(757) 875-2016
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
PL005216
VA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
PL005216
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008730784
—
VA
Enumeration date
08/21/2006
Last updated
01/26/2021
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