Provider Demographics
NPI:1770768988
Name:CJW MEDICAL CENTER
Entity type:Organization
Organization Name:CJW MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:804-560-6500
Mailing Address - Street 1:500 HIOAKS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4061
Mailing Address - Country:US
Mailing Address - Phone:804-560-6500
Mailing Address - Fax:
Practice Address - Street 1:500 HIOAKS RD
Practice Address - Street 2:SUITE A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4061
Practice Address - Country:US
Practice Address - Phone:804-560-6500
Practice Address - Fax:804-560-6505
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CJW MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306001502282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital