Provider Demographics
NPI:1326764572
Name:MARTHA JEFFERSON HOSPITAL
Entity Type:Organization
Organization Name:MARTHA JEFFERSON HOSPITAL
Other - Org Name:THE SOMETHING SPECIAL SHOP AT SRMH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIR, FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:THEXTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-654-8199
Mailing Address - Street 1:500 MARTHA JEFFERSON DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-4668
Mailing Address - Country:US
Mailing Address - Phone:434-654-8199
Mailing Address - Fax:
Practice Address - Street 1:2275 HEALTH CAMPUS DR STE 120
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8809
Practice Address - Country:US
Practice Address - Phone:540-689-4700
Practice Address - Fax:540-689-4701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-18
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies