Provider Demographics
NPI:1659381242
Name:ROCKINGHAM MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:ROCKINGHAM MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:J.
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BURRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-689-1245
Mailing Address - Street 1:2010 HEALTH CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-8679
Mailing Address - Country:US
Mailing Address - Phone:540-689-1200
Mailing Address - Fax:540-689-1220
Practice Address - Street 1:411 STONE SPRING RD
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-9660
Practice Address - Country:US
Practice Address - Phone:540-433-4429
Practice Address - Fax:540-433-4193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHSP-0654251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4910338Medicaid
VA4910338Medicaid