Organization
CRATER COMMUNITY HOSPICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA D. MITCHELL RN, MSN, CS, CHPN (CEO)
(804) 526-4300
Entity
Organization
Contact information
Practice address
3916 S CRATER RD, PETERSBURG, VA 23805-9202
(804) 526-4300
(804) 526-4924
Mailing address
3916 S CRATER RD, PETERSBURG, VA 23805-9202
(804) 526-4300
(804) 526-4337
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
0515-15
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004910192
—
VA
01
—
337221
BLUE CROSS PROVIDER ID
—
Enumeration date
06/17/2005
Last updated
06/09/2010
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