Provider Demographics
NPI:1093879744
Name:CHATUGE REGIONAL HOSPITAL INC
Entity Type:Organization
Organization Name:CHATUGE REGIONAL HOSPITAL INC
Other - Org Name:HAYESVILLE FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NICK
Authorized Official - Middle Name:
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-439-6469
Mailing Address - Street 1:35 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30512-3139
Mailing Address - Country:US
Mailing Address - Phone:828-389-2273
Mailing Address - Fax:828-389-8291
Practice Address - Street 1:450 HWY 64 BUSINESS
Practice Address - Street 2:SUITE 4
Practice Address - City:HAYESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28904-9694
Practice Address - Country:US
Practice Address - Phone:828-389-2273
Practice Address - Fax:828-389-8291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC018EROtherBCBS GROUP
NC018EROtherBCBS GROUP
GA34-3456Medicare PIN