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Organization

RIVERSIDE TAPPAHANNOCK HOSPITAL INC

Active
Other names
Riverside Tappahannock Hospital
Organization subpart
No

Provider details

NPI number
Authorized official
WADE DUDLEY BROUGHMAN (EXECUTIVE VICE PRESIDENT/CFO)
(757) 591-7019
Entity
Organization

Contact information

Practice address
618 HOSPITAL RD, TAPPAHANNOCK, VA 22560-5000
(804) 443-3311
(804) 443-6150
Mailing address
606 DENBIGH BLVD, SUITE 800, NEWPORT NEWS, VA 23608-4413
(757) 875-7545
(757) 875-7553

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
H1889
VA
332B00000X
Durable Medical Equipment & Medical Supplies
H1889
VA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
H1889
VA

Other

Enumeration date
09/08/2006
Last updated
09/11/2025
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