Provider Demographics
NPI:1619928017
Name:WINCHESTER MEDICAL CENTER
Entity Type:Organization
Organization Name:WINCHESTER MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP & CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:AMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-536-2607
Mailing Address - Street 1:220 CAMPUS BLVD STE 310
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2889
Mailing Address - Country:US
Mailing Address - Phone:540-536-8000
Mailing Address - Fax:540-536-7681
Practice Address - Street 1:1840 AMHERST ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2808
Practice Address - Country:US
Practice Address - Phone:540-536-8000
Practice Address - Fax:540-536-7681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAH 1916282N00000X, 282N00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD005055500Medicaid
VA148653500OtherUS DEPARTMENT OF LABOR
VA2121886OtherMAMSI,MAPSI,ALLIANCE
FL092338900Medicaid
VA0059412OtherUNITED MINE WORKERS - IP
VA000039OtherANTHEM
VA004900057OtherSLH
VA2121886OtherOPTIMUM CHOICE, MDIPA
VA004900057Medicaid
VA0059420OtherUNITED MINE WORKERS-OP
VA531929OtherNCPPO
WV0001738000Medicaid
VA004900057Medicaid
VA148653500OtherUS DEPARTMENT OF LABOR
VA490005Medicare Oscar/Certification