Organization
PETERSBURG HOSPITAL COMPANY LLC
Active
Other names
Healthcare Plus
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA M LALOR (DIRECTOR/DELEGATED OFFICIAL)
(615) 925-4565
Entity
Organization
Contact information
Practice address
436 CLAREMONT CT, COLONIAL HEIGHTS, VA 23834-1765
(804) 862-5000
Mailing address
PO BOX 501128, ST. LOUIS, MO 63150-1128
(804) 526-2121
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
188948
ANTHEM BLUE CR BLUE SH
VA
Enumeration date
01/29/2007
Last updated
08/03/2017
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