Healthcare Provider Details

I. General information

NPI: 1104083385
Provider Name (Legal Business Name): WINCHESTER MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 10/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W CORK ST SUITE 145
WINCHESTER VA
22601-3870
US

IV. Provider business mailing address

333 W CORK ST SUITE 145
WINCHESTER VA
22601-3870
US

V. Phone/Fax

Practice location:
  • Phone: 540-536-5122
  • Fax: 540-536-5340
Mailing address:
  • Phone: 540-536-5122
  • Fax: 540-536-5340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: BAMBIE COMPHER
Title or Position: PRACTICE MANAGER
Credential:
Phone: 540-536-5122