# FAUQUIER HOSPITAL AUXILIARY

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

## Provider details

- **NPI number:** 1194378737
- **Authorized official:** DIANE MARIE VON GOELLNER-SUPPA (MANAGER)
- **Authorized official phone:** (540) 316-4437

## Contact information

- **Practice address:** 500 HOSPITAL DR, THE CARE BOUTIQUE, WARRENTON, VA 20186
- **Practice address phone:** (540) 316-4437
- **Mailing address:** 500 HOSPITAL DR, THE CARE BOUTIQUE, WARRENTON, VA 20186
- **Mailing address phone:** (540) 316-4437

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 224900000X | Mastectomy Fitter | — | NULL | Yes |
| 224900000X | Mastectomy Fitter | — | — | Yes |

## Other

- **Enumeration date:** 07/23/2019
- **Last updated:** 07/23/2019