Organization
EASTERN SHORE RURAL HEALTH SYSTEM INCORPORATED
Active
Other names
Kiptopeke Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNETTE EDWARDS (CHIEF EXECUTIVE OFFICER)
(757) 414-0400
Entity
Organization
Contact information
Practice address
24023 FAIRVIEW RD, CAPE CHARLES, VA 23310-2153
(757) 331-1048
Mailing address
20280 MARKET ST, ONANCOCK, VA 23417-1331
(757) 414-0400
(757) 414-0569
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
03/03/2022
Last updated
03/22/2023
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