# SHENANDOAH MEMORIAL HOSPITAL INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053842468
- **Authorized official:** RENEE Y BAKER (MANGER, INSURANCE CREDENTIALING)
- **Authorized official phone:** (540) 536-0231

## Contact information

- **Practice address:** 5173 MAIN ST, MOUNT JACKSON, VA 22842-9513
- **Practice address phone:** (540) 459-1350
- **Practice address fax:** (540) 459-1351
- **Mailing address:** 5173 MAIN ST, MOUNT JACKSON, VA 22842-9513
- **Mailing address phone:** (540) 459-1350
- **Mailing address fax:** (540) 459-1351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 261QR0200X | Radiology Clinic/Center | — | NULL | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/27/2017
- **Last updated:** 04/06/2020