Provider Demographics
NPI:1124194063
Name:THE FAUQUIER HOSPITAL INC
Entity Type:Organization
Organization Name:THE FAUQUIER HOSPITAL INC
Other - Org Name:BLACKWELL ROAD LOCATION
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RODGER
Authorized Official - Middle Name:H
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-316-5012
Mailing Address - Street 1:500 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-3027
Mailing Address - Country:US
Mailing Address - Phone:540-316-5012
Mailing Address - Fax:540-316-5012
Practice Address - Street 1:493 BLACKWELL RD
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2639
Practice Address - Country:US
Practice Address - Phone:540-316-5012
Practice Address - Fax:540-316-5012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAH1851282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4900235Medicaid
VA4900235Medicaid