1871507699 NPI number — CUMBERLAND HOSPITAL LLC

Table of content: (NPI 1871507699)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871507699 NPI number — CUMBERLAND HOSPITAL LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CUMBERLAND HOSPITAL LLC
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:
CUMBERLAND HOSPITAL
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:
1871507699
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/02/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9407 CUMBERLAND ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW KENT
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23124-2029
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-966-2242
Provider Business Mailing Address Fax Number:
804-966-1643

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9407 CUMBERLAND ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW KENT
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23124-9407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-966-2242
Provider Business Practice Location Address Fax Number:
804-966-1643
Provider Enumeration Date:
07/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FILTON
Authorized Official First Name:
STEVE
Authorized Official Middle Name:
Authorized Official Title or Position:
SRVPCFO
Authorized Official Telephone Number:
610-768-3300

Provider Taxonomy Codes

  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0804X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 273R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 320600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 842126900 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 914049200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 034152200 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0493300 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 402294700 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000207241 . This is a "MEDICAID RESIDENTIAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01682806 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4903300 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01600691 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0586446 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8885001 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: AHS3300N , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000938605X , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0019133520001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 004933001 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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