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Contact Information

TAZEWELL LIFE CARE, LLC
282 BEN BOLT AVE
TAZEWELL, VA24651
 Phone: 276-988-2515
 Fax: 276-988-5468
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for TAZEWELL LIFE CARE, LLC

NPI Number 1538159926
LBN Legal business name TAZEWELL LIFE CARE, LLC
Authorized official CASSANDRA GALLANT - (COMPLIANCE & PRIVACY OFFICER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/26/2005
Last updated 11/25/2024 - More than a year ago
Identifiers
VA License # NH2581
VA Medicaid 4951522
VA Other 180511 ANTHEM BCBS PROVIDER ID
VA Other 418359 COMBINED IN CO OF AMERICA
VA Other 200515601 FEDERAL BLACK LUNG ID
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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