Organization
HALIFAX REGIONAL HOSPITAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE WOMACK ELLIOTT (COORDINATOR THIRD PARTY PAYERS)
(434) 517-3156
Entity
Organization
Contact information
Practice address
2204 WILBORN AVE, SOUTH BOSTON, VA 24592-1645
(434) 517-3100
(434) 517-3819
Mailing address
2204 WILBORN AVE, SOUTH BOSTON, VA 24592-1645
(434) 517-3100
(434) 517-3819
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
H1853
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000054
ANTHEM PROVIDER #
VA
05
—
004900138
—
VA
05
—
004952294
—
VA
05
—
8536228
—
VA
Enumeration date
11/02/2005
Last updated
07/08/2010
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