Healthcare Provider Details

I. General information

NPI: 1457564502
Provider Name (Legal Business Name): WARREN MEMORIAL HOSPITAL OCCUPAITONAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N SHENANDOAH AVE
FRONT ROYAL VA
22630-3547
US

IV. Provider business mailing address

1000 N SHENANDOAH AVE
FRONT ROYAL VA
22630-3547
US

V. Phone/Fax

Practice location:
  • Phone: 540-636-0259
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number StateVA

VIII. Authorized Official

Name: DENISE EASTHAM
Title or Position: CORPORATE DIRECTOR
Credential:
Phone: 540-636-0259