Provider Demographics
NPI:1871574368
Name:BEDFORD MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:BEDFORD MEMORIAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:
Authorized Official - Last Name:JURKUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-587-3385
Mailing Address - Street 1:PO BOX 41000
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24506-4100
Mailing Address - Country:US
Mailing Address - Phone:434-200-1816
Mailing Address - Fax:434-200-6638
Practice Address - Street 1:1613 OAKWOOD ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-1213
Practice Address - Country:US
Practice Address - Phone:434-200-1816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA495046Medicare Oscar/Certification
VA0419090001Medicare NSC