Organization Name: | WILLIAMSBURG REGIONAL HOSPITAL |
NPI Number: | 1205102738 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LIBBY DORRELL (PRACTICE MANAGER) |
Mailing Address: | 500 Thurgood Marshall Hwy Suite A Kingstree |
State: | SC US |
Postal Code: | 295564143 |
Phone Number: | 8433550201 |
Fax Number: | |
NPI Enumeration Date: | 03/29/2012 |
NPI Last Update Date: | 03/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Multi-Specialty |
Taxonomy Definition: |