Basic Information
| Provider Information | |||||||||
| NPI: | 1871507699 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CUMBERLAND HOSPITAL LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CUMBERLAND HOSPITAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9407 CUMBERLAND ROAD | ||||||||
| Address2: | |||||||||
| City: | NEW KENT | ||||||||
| State: | VA | ||||||||
| PostalCode: | 231242029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8049662242 | ||||||||
| FaxNumber: | 8049661643 | ||||||||
| Practice Location | |||||||||
| Address1: | 9407 CUMBERLAND ROAD | ||||||||
| Address2: | |||||||||
| City: | NEW KENT | ||||||||
| State: | VA | ||||||||
| PostalCode: | 231249407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8049662242 | ||||||||
| FaxNumber: | 8049661643 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2006 | ||||||||
| LastUpdateDate: | 06/02/2021 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | FILTON | ||||||||
| AuthorizedOfficialFirstName: | STEVE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | SRVPCFO | ||||||||
| AuthorizedOfficialTelephone: | 6107683300 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 06/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics | 2084P0804X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | 320600000X | N | Residential Treatment Facilities | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 363L00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LP0200X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics | 282N00000X | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 01600691 | 05 | KY | MEDICAID | 034152200 | 05 | DC | MEDICAID | 4903300 | 05 | NC | MEDICAID | 842126900 | 05 | MN | MEDICAID | 914049200 | 05 | FL | MEDICAID | 0019133520001 | 05 | PA | MEDICAID | 01682806 | 05 | NY | MEDICAID | 402294700 | 05 | MD | MEDICAID | 000207241 | 01 | MEDICAID RESIDENTIAL | OTHER | 000938605X | 05 | GA | MEDICAID | 004933001 | 05 | VA | MEDICAID | 8885001 | 05 | NJ | MEDICAID | 0493300 | 05 | VT | MEDICAID | 0586446 | 05 | IA | MEDICAID | AHS3300N | 05 | AL | MEDICAID |