=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336951581
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WINCHESTER MEDICAL CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/24/2025
-----------------------------------------------------
Last Update Date | 04/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 190 CAMPUS BLVD STE 201
-----------------------------------------------------
City | WINCHESTER
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22601-2872
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-536-5980
-----------------------------------------------------
Fax | 540-536-5979
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 220 CAMPUS BLVD STE 320
-----------------------------------------------------
City | WINCHESTER
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22601-2889
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-536-5100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER INSURANCE CREDENTIALING
-----------------------------------------------------
Name | JILL CHAMBERS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 540-536-0231
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------