Provider Demographics
NPI:1841394566
Name:SHENANDOAH MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:SHENANDOAH MEMORIAL HOSPITAL
Other - Org Name:VALLEY BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KILMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-459-1100
Mailing Address - Street 1:759 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22664-1127
Mailing Address - Country:US
Mailing Address - Phone:540-459-1262
Mailing Address - Fax:540-459-1293
Practice Address - Street 1:759 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VA
Practice Address - Zip Code:22664-1127
Practice Address - Country:US
Practice Address - Phone:540-459-1262
Practice Address - Fax:540-459-1293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC00248Medicare PIN