Provider Demographics
NPI:1457840183
Name:WARREN MEMORIAL HOSPITAL, INC.
Entity Type:Organization
Organization Name:WARREN MEMORIAL HOSPITAL, INC.
Other - Org Name:VALLEY HEALTH MULTISPECIALTY CLINIC COMMERCE AVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER INSURANCE CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-536-0231
Mailing Address - Street 1:220 CAMPUS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2896
Mailing Address - Country:US
Mailing Address - Phone:540-536-5100
Mailing Address - Fax:540-536-0235
Practice Address - Street 1:120 N. COMMERCE AVE
Practice Address - Street 2:STE 103, 230, 245 AND 255
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630
Practice Address - Country:US
Practice Address - Phone:540-635-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WARREN MEMORIAL HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-08
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X, 207V00000X, 207Y00000X, 208000000X, 261QR1300X
VA208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty