Provider Demographics
NPI:1912329749
Name:FAUQUIER FREE CLINIC
Entity Type:Organization
Organization Name:FAUQUIER FREE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-347-0394
Mailing Address - Street 1:PO BOX 3138
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20188
Mailing Address - Country:US
Mailing Address - Phone:540-347-0394
Mailing Address - Fax:540-349-3262
Practice Address - Street 1:35 ROCK POINTE LANE
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-3009
Practice Address - Country:US
Practice Address - Phone:540-347-0394
Practice Address - Fax:540-349-3262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-14
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty