Provider Demographics
NPI:1841295516
Name:THE FAUQUIER HOSPITAL INC
Entity type:Organization
Organization Name:THE FAUQUIER HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RODGER
Authorized Official - Middle Name:H
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-316-5013
Mailing Address - Street 1:493 BLACKWELL RD
Mailing Address - Street 2:STE 317
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2628
Mailing Address - Country:US
Mailing Address - Phone:540-316-2737
Mailing Address - Fax:
Practice Address - Street 1:493 BLACKWELL RD
Practice Address - Street 2:STE 317
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2628
Practice Address - Country:US
Practice Address - Phone:540-316-2737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE FAUQUIER HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA497299B251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006543OtherBLUE CROSS BLUE SHIELD
VA4972996Medicaid
VA497299Medicare PIN