Basic Information
| Provider Information | |||||||||
| NPI: | 1538108998 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SHELTERING ARMS HOSPITAL | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | SHELTERING ARMS REHABILITATION HOSPTIAL | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8254 ATLEE RD | ||||||||
| Address2: | |||||||||
| City: | MECHANICSVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 231161844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8043424358 | ||||||||
| FaxNumber: | 8043424316 | ||||||||
| Practice Location | |||||||||
| Address1: | 8254 ATLEE RD | ||||||||
| Address2: | |||||||||
| City: | MECHANICSVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 231161844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8043424358 | ||||||||
| FaxNumber: | 8043424316 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2006 | ||||||||
| LastUpdateDate: | 03/23/2016 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | ZWEIFEL | ||||||||
| AuthorizedOfficialFirstName: | MARY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT AND CEO | ||||||||
| AuthorizedOfficialTelephone: | 8043424325 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283X00000X | H1899 | VA | Y | Hospitals | Rehabilitation Hospital |
ID Information
| ID | Type | State | Issuer | Description | 6562113 | 01 | VA | AETNA | OTHER | 67900 | 01 | VA | OPTIMA INPATIENT | OTHER | 0719271 | 01 | VA | CIGNA | OTHER | 220582 | 01 | VA | MAMSI | OTHER | C01772 | 01 | VA | GROUP MEDICARE NUMBER | OTHER | 37467 | 01 | VA | OPTIMA OUTPATIENT | OTHER | C06541 | 01 | VA | GROUP MEDICARE NUMBER | OTHER | 004930002 | 05 | VA | MEDICAID | 258472 | 01 | VA | SOUTHERN HEALTH | OTHER | 31864 | 01 | VA | CARENET | OTHER | 000121 | 01 | VA | ANTHEM | OTHER | CE3017 | 01 | VA | GROUP MEDICARE NUMBER | OTHER |