Healthcare Provider Details

I. General information

NPI: 1255465175
Provider Name (Legal Business Name): AUGUSTA HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 MEDICAL CENTER DRIVE
FISHERSVILLE VA
22939
US

IV. Provider business mailing address

PO BOX 1000
FISHERSVILLE VA
22939-1000
US

V. Phone/Fax

Practice location:
  • Phone: 540-932-4000
  • Fax: 540-932-4616
Mailing address:
  • Phone: 540-932-4629
  • Fax: 540-932-4616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM J MEADOR
Title or Position: CFO
Credential:
Phone: 540-932-4000