Provider Demographics
NPI:1033413323
Name:WILLIAMSBURG REGIONAL HOSPITAL
Entity Type:Organization
Organization Name:WILLIAMSBURG REGIONAL HOSPITAL
Other - Org Name:WILLIAMSBURG REGIONAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DORRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-355-0197
Mailing Address - Street 1:500 THURGOOD MARSHALL HWY
Mailing Address - Street 2:SUITE F
Mailing Address - City:KINGTREE
Mailing Address - State:SC
Mailing Address - Zip Code:29556
Mailing Address - Country:US
Mailing Address - Phone:843-355-1772
Mailing Address - Fax:843-355-1775
Practice Address - Street 1:500 THURGOOD MARSHALL HWY
Practice Address - Street 2:SUITE F
Practice Address - City:KINGSTREE
Practice Address - State:SC
Practice Address - Zip Code:29556
Practice Address - Country:US
Practice Address - Phone:843-355-1772
Practice Address - Fax:843-355-1775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-01
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health