MEDICARE: PAGE MEMORIAL HOSPITAL, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital	H1880	VA
2	282NC0060X	Critical Access Hospital	H1880	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000027	OTHER	VA	ANTHEM BCBS

General Provider Information

NPI Number	:	1326040684
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAGE MEMORIAL HOSPITAL, INC.

Provider Business Mailing Address
First Line	:	220 CAMPUS BLVD STE 200
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22601-2889
Country	:	US
Telephone Number	:	540-536-5100
Fax Number	:	540-536-0235

Provider Business Practice Location Address
First Line	:	200 MEMORIAL DR
Second Line	:
City	:	LURAY
State	:	VA
Zip	:	22835
Country	:	US
Telephone Number	:	540-743-4561
Fax Number	:	540-743-9560

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	RENEE NEVADA JOHNSON
Credential	:
Telephone Number	:	540-536-0103

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	08/18/2018

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Directions to “PAGE MEMORIAL HOSPITAL, INC. ” Practice Location

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