Provider Demographics
NPI:1336566942
Name:CHESAPEAKE CARE, INC.
Entity type:Organization
Organization Name:CHESAPEAKE CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:REVELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-545-5700
Mailing Address - Street 1:2145 S MILITARY HWY
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4426
Mailing Address - Country:US
Mailing Address - Phone:757-545-5700
Mailing Address - Fax:757-961-0471
Practice Address - Street 1:2145 S MILITARY HWY
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4426
Practice Address - Country:US
Practice Address - Phone:757-545-5700
Practice Address - Fax:757-961-0471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-20
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental