Eastern Shore Rural Health System Incorporated
Organization Active NPI Federally Qualified Health Center (FQHC) · Parksley, VA
NPI 1043463227 · NPPES record last updated Mar 22, 2023
Key facts
- NPI
- 1043463227
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- EASTERN SHORE RURAL HEALTH SYSTEM INCORPORATED
- Practice address
- 24501 Parksley Rd
Parksley, VA 23421-2519 - Phone
- (757) 665-1159
- Fax
- (757) 665-1846
- NPI assigned
- Oct 31, 2008
- Organization subpart
- No
Authorized official
- Name
- Jeannette Edwards
- Title
- Chief Executive Officer
- Phone
- (757) 414-0400
Corporate family (same tax ID) 9
Practitioners 13
-
Bipana Baral, BDS
-
Christina Ulloa Bollinger, D.D.S.
-
Joshua N Carter, DDS
-
Nidya De la Torre, DDS
-
Joe Richard Drake, D.D.S.
-
Carsten F Frey, DDS
-
Edward Nicholas Griggs III, D.D.S.
-
Tiffany Nightengale, DMD
-
Randi Wingate, D.D.S.
-
Scott Brian Wolpin, DMD
National Provider Directory
- Tax ID family
- Eastern Shore Rural Health System Incorporated
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
24501 Parksley Rd
Parksley, VA 23421-2519
Mailing address
20280 Market St
Onancock, VA 23417-1331
Phone (757) 414-0431
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008450552 | Medicaid | VA |
Other names
- Metompkin Elementary School Dental Program
Other providers in Parksley, VA
- Mary A Clark
- Lilian Davalos
- Nidya De la Torre
- Eastern Shore Community MH Mr Sas Services Board
- Eastern Shore Community Services Board
- Lindsay Evans
- Tian Fei
- Scott Field
- Caitlin Ford
- Cynthia Dize Franklin
All providers in Parksley, VA · Federally Qualified Health Center (FQHC) in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.