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Organization
FAUQUIER HOSPITAL AUXILIARY
Active
Organization
FAUQUIER HOSPITAL AUXILIARY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE MARIE VON GOELLNER-SUPPA (MANAGER)
(540) 316-4437
Entity
Organization
Contact information
Practice address
500 HOSPITAL DR, THE CARE BOUTIQUE, WARRENTON, VA 20186
(540) 316-4437
Mailing address
500 HOSPITAL DR, THE CARE BOUTIQUE, WARRENTON, VA 20186
(540) 316-4437
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
—
NULL
224900000X
Mastectomy Fitter
Primary
—
—
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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