Healthcare Provider Details

I. General information

NPI: 1295728491
Provider Name (Legal Business Name): BEDFORD MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 06/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1613 OAKWOOD ST
BEDFORD VA
24523-1213
US

IV. Provider business mailing address

PO BOX 13966
ROANOKE VA
24038-3966
US

V. Phone/Fax

Practice location:
  • Phone: 540-586-2441
  • Fax: 540-224-5507
Mailing address:
  • Phone: 540-586-2441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberH 1828
License Number StateVA

VIII. Authorized Official

Name: MRS. REBECCA H JOHNSON
Title or Position: DIRECTOR, PROFESSIONAL BILLING
Credential:
Phone: 540-224-5715