Healthcare Provider Details

I. General information

NPI: 1740711472
Provider Name (Legal Business Name): SHENANDOAH MEMORIAL HOSPITAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2017
Last Update Date: 06/03/2021
Certification Date: 06/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9166 N CONGRESS ST
NEW MARKET VA
22844-9422
US

IV. Provider business mailing address

9166 N CONGRESS ST
NEW MARKET VA
22844-9422
US

V. Phone/Fax

Practice location:
  • Phone: 540-459-1340
  • Fax: 540-459-1349
Mailing address:
  • Phone: 540-459-1340
  • Fax: 540-459-1349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RENEE Y BAKER
Title or Position: MANGER, INSURANCE CREDENTIALING
Credential:
Phone: 540-536-0231