Healthcare Provider Details

I. General information

NPI: 1437334141
Provider Name (Legal Business Name): COMMUNITY PHYSICIANS OF WAR MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2008
Last Update Date: 01/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 WAR MEMORIAL DR
BERKELEY SPRINGS WV
25411-1737
US

IV. Provider business mailing address

136 LINDEN DR SUITE 104
WINCHESTER VA
22601-2818
US

V. Phone/Fax

Practice location:
  • Phone: 304-258-0506
  • Fax: 304-258-0508
Mailing address:
  • Phone: 540-678-3588
  • Fax: 540-678-9025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number11048
License Number StateWV

VIII. Authorized Official

Name: ROSEMARIE REYNOLDS
Title or Position: PHYSICIAN PRACTICE MANAGER
Credential:
Phone: 540-247-2701