Provider Demographics
NPI:1225208705
Name:DANVILLE REGIONAL MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:DANVILLE REGIONAL MEDICAL CENTER, LLC
Other - Org Name:SOVAH HEALTH MARTINSVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:TERRANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7220
Mailing Address - Street 1:330 SEVEN SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4536
Mailing Address - Country:US
Mailing Address - Phone:615-920-7000
Mailing Address - Fax:615-920-8913
Practice Address - Street 1:320 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-1900
Practice Address - Country:US
Practice Address - Phone:276-666-7647
Practice Address - Fax:276-666-0363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2022-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101230513207T00000X
VA101044867207T00000X
VA101031630207T00000X
VA1010532282084N0600X
VA101042317208600000X
VA101057668208600000X
282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007118147Medicaid
1841217932OtherNPI
1942269766OtherNPI
VA007118121Medicaid
1851382873OtherNPI
VA007313063Medicaid
1073501383OtherNPI
VA004900791Medicaid
VA007118139Medicaid
VA007313055Medicaid
VA007118155Medicaid
1669462859OtherNPI
1881684074OtherNPI
1881684074OtherNPI
VA130000831Medicare PIN
VA007118147Medicaid
VA004900791Medicaid
VA260003096Medicare PIN
1073501383OtherNPI
VA007118155Medicaid
VA007118121Medicaid