Healthcare Provider Details

I. General information

NPI: 1205200599
Provider Name (Legal Business Name): CHIPPENHAM & JOHNSTON-WILLIS HOSPITALS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2015
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14720 HANCOCK VILLAGE STREET
CHESTERFIELD VA
23832
US

IV. Provider business mailing address

14720 HANCOCK VILLAGE STREET
CHESTERFIELD VA
23832
US

V. Phone/Fax

Practice location:
  • Phone: 804-320-3911
  • Fax: 804-323-8049
Mailing address:
  • Phone: 804-320-3911
  • Fax: 804-323-8049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DUSTIN FOSNESS
Title or Position: CFO
Credential:
Phone: 804-483-0813