Provider Demographics
NPI:1205200599
Name:CHIPPENHAM & JOHNSTON-WILLIS HOSPITALS, INC.
Entity type:Organization
Organization Name:CHIPPENHAM & JOHNSTON-WILLIS HOSPITALS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
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 1:14720 HANCOCK VILLAGE STREET
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832
Mailing Address - Country:US
Mailing Address - Phone:804-320-3911
Mailing Address - Fax:804-323-8049
Practice Address - Street 1:14720 HANCOCK VILLAGE STREET
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832
Practice Address - Country:US
Practice Address - Phone:804-320-3911
Practice Address - Fax:804-323-8049
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHIPPENHAM & JOHNSTON-WILLIS HOSPITALS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-24
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care