Basic Information
| Provider Information | |||||||||
| NPI: | 1376781294 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | WARREN MEMORIAL HOSPITAL, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | WARREN MEMORIAL HOSPITAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 N SHENANDOAH AVE | ||||||||
| Address2: | |||||||||
| City: | FRONT ROYAL | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226303547 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406360300 | ||||||||
| FaxNumber: | 5406360198 | ||||||||
| Practice Location | |||||||||
| Address1: | 120 N COMMERCE AVE | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | FRONT ROYAL | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226304417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406360300 | ||||||||
| FaxNumber: | 5406360198 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2009 | ||||||||
| LastUpdateDate: | 02/22/2010 | ||||||||
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| AuthorizedOfficialLastName: | NOLAN | ||||||||
| AuthorizedOfficialFirstName: | PATRICK | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5406360300 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | WARREN MEMORIAL HOSPITAL, INC. | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | H 1913 | VA | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.