Basic Information
| Provider Information | |||||||||
| NPI: | 1669540431 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SHELTERING ARMS HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8254 ATLEE RD | ||||||||
| Address2: | |||||||||
| City: | MECHANICSVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 231161844 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 8254 ATLEE RD | ||||||||
| Address2: | |||||||||
| City: | MECHANICSVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 231161844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8043424300 | ||||||||
| FaxNumber: | 8043424316 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2006 | ||||||||
| LastUpdateDate: | 06/18/2008 | ||||||||
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| AuthorizedOfficialLastName: | BOEMMEL | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP FINANCE, CFO | ||||||||
| AuthorizedOfficialTelephone: | 8043424340 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
ID Information
| ID | Type | State | Issuer | Description | 004930002 | 05 | VA | MEDICAID |