Healthcare Provider Details

I. General information

NPI: 1356153415
Provider Name (Legal Business Name): WINCHESTER MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 COSTELLO DR STE B
WINCHESTER VA
22602-4686
US

IV. Provider business mailing address

220 CAMPUS BLVD STE 320
WINCHESTER VA
22601-2889
US

V. Phone/Fax

Practice location:
  • Phone: 540-536-5400
  • Fax: 540-536-5490
Mailing address:
  • Phone: 540-536-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JILL CHAMBERS
Title or Position: MANAGER INSURANCE CREDENTIALING
Credential:
Phone: 540-536-0231