1316943277 NPI number — CHESAPEAKE HOSPITAL AUTHORITY

Table of content: (NPI 1316943277)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316943277 NPI number — CHESAPEAKE HOSPITAL AUTHORITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHESAPEAKE HOSPITAL AUTHORITY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CHESAPEAKE REGIONAL HOME AND SUPPORTIVE CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316943277
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/31/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1301 EXECUTIVE BLVD STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHESAPEAKE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23320-3671
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-312-6460
Provider Business Mailing Address Fax Number:
757-312-6477

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1301 EXECUTIVE BLVD STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHESAPEAKE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23320-3671
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-312-6460
Provider Business Practice Location Address Fax Number:
757-312-6477
Provider Enumeration Date:
06/24/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
EGYUD
Authorized Official First Name:
AMBER
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF OPERATING OFFICER/CHIEF NURSI
Authorized Official Telephone Number:
757-312-6308

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00497279 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".