Provider Demographics
NPI:1225287337
Name:PAGE MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:PAGE MEMORIAL HOSPITAL
Other - Org Name:PAGE MEMORIAL HOSPITAL CONVENIENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR CLINICAL FINANCIAL APPS
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-536-8290
Mailing Address - Street 1:200 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:LURAY
Mailing Address - State:VA
Mailing Address - Zip Code:22835-1000
Mailing Address - Country:US
Mailing Address - Phone:540-743-4561
Mailing Address - Fax:540-743-9560
Practice Address - Street 1:200 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:LURAY
Practice Address - State:VA
Practice Address - Zip Code:22835-1000
Practice Address - Country:US
Practice Address - Phone:540-743-4561
Practice Address - Fax:540-743-9560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-12
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAH1926261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1326040684Medicaid
VA491307Medicare PIN