Emporia Manor LLC

Organization Active NPI Nursing Facility/Intermediate Care Facility · Emporia, VA

NPI 1790767259 · NPPES record last updated Jul 15, 2016

Key facts

NPI
1790767259
Entity type
Organization (NPI type 2)
Primary specialty
Nursing Facility/Intermediate Care Facility 313M00000X
Legal business name
EMPORIA MANOR LLC
Practice address
200 Weaver Ave
Emporia, VA 23847-1230
Phone
(434) 634-6581
Fax
(434) 634-4069
NPI assigned
Nov 18, 2005
Organization subpart
No

Authorized official

Name
Mr. Karl Keffer
Title
Administrator
Phone
(434) 634-6581

National Provider Directory

Locations

200 Weaver Ave
Emporia, VA 23847
Phone (434) 634-6581

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X Yes

Addresses

Primary practice location

200 Weaver Ave
Emporia, VA 23847-1230

Mailing address

200 Weaver Ave
Emporia, VA 23847-1230
Phone (434) 634-6581

Other identifiers

IdentifierTypeStateIssuer
010051088MedicaidVA

Other providers in Emporia, VA

All providers in Emporia, VA · Nursing Facility/Intermediate Care Facility in Virginia

Sources for this page

Verify at the official NPI Registry.