Provider Demographics
NPI:1598708513
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 1:7102 JAHNKE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4018
Practice Address - Country:US
Practice Address - Phone:804-320-3911
Practice Address - Fax:804-323-8049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000448214XMedicaid
OH0444264Medicaid
150249500OtherDEPT OF LABOR
AR161195105Medicaid
ALHOS0112NMedicaid
032025600OtherBLACK LUNG
IA0716167Medicaid
MA1010239Medicaid
AR161195101Medicaid
333302OtherMAMSI
339008OtherNCPPO
NY00618319Medicaid
MA1212419Medicaid
ME178250001Medicaid
NJ4223802Medicaid
VA004901126Medicaid
DC037814300Medicaid
339008OtherNC PPO
50988600031OtherQUALCHOICE
VA261090OtherWELLPOINT
FL901658900Medicaid
SC10325AMedicaid
150249500OtherDEPARTMENT OF LABOR
DC037814300Medicaid