Basic Information
| Provider Information | |||||||||
| NPI: | 1427085232 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WARREN MEMORIAL HOSPITAL, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 220 CAMPUS BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | WINCHESTER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226012896 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405365100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 NORTH SHENANDOAH AVE | ||||||||
| Address2: | |||||||||
| City: | FRONT ROYAL | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226303547 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406360300 | ||||||||
| FaxNumber: | 5406360198 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2006 | ||||||||
| LastUpdateDate: | 05/27/2021 | ||||||||
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| AuthorizedOfficialLastName: | CHAMBERS | ||||||||
| AuthorizedOfficialFirstName: | JILL | ||||||||
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| AuthorizedOfficialTitleorPosition: | MGR INS CREDENTIALING | ||||||||
| AuthorizedOfficialTelephone: | 5405360231 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | H1913 | VA | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 4900332 | 05 | VA | MEDICAID | 0036256000 | 05 | WV | MEDICAID | 11551 | 01 | SOUTHERN HEALTH | OTHER | 2121887 | 01 | VA | ALLIANCE | OTHER | 000044 | 01 | VA | ANTHEM | OTHER | 531939 | 01 | VA | NCPPO | OTHER |