Provider Demographics
NPI:1184757973
Name:MARY WASHINGTON HOSPITAL
Entity type:Organization
Organization Name:MARY WASHINGTON HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-741-1100
Mailing Address - Street 1:1101 SAM PERRY BLVD
Mailing Address - Street 2:STE 219
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-4467
Mailing Address - Country:US
Mailing Address - Phone:540-741-2865
Mailing Address - Fax:
Practice Address - Street 1:1101 SAM PERRY BLVD
Practice Address - Street 2:STE 219
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4467
Practice Address - Country:US
Practice Address - Phone:540-741-2865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital