Provider Demographics
NPI:1184664039
Name:CHIPPENHAM & JOHNSTON-WILLIS HOSPITALS INC
Entity Type:Organization
Organization Name:CHIPPENHAM & JOHNSTON-WILLIS HOSPITALS INC
Other - Org Name:CJW MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSNESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-483-0813
Mailing Address - Street 1:7101 JAHNKE RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4017
Mailing Address - Country:US
Mailing Address - Phone:804-320-3911
Mailing Address - Fax:804-323-8049
Practice Address - Street 1:7101 JAHNKE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4017
Practice Address - Country:US
Practice Address - Phone:804-320-3911
Practice Address - Fax:804-323-8049
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHIPPENHAM & JOHNSTON-WILLIS HOSPITALS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-08
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004930061Medicaid
49T112Medicare Oscar/Certification