Provider Demographics
NPI:1265473755
Name:GALEN-MED, INC.
Entity Type:Organization
Organization Name:GALEN-MED, INC.
Other - Org Name:CLINCH VALLEY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:HARALSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-596-6672
Mailing Address - Street 1:2949 WEST FRONT ST
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641-2099
Mailing Address - Country:US
Mailing Address - Phone:276-596-6000
Mailing Address - Fax:276-596-6009
Practice Address - Street 1:2949 WEST FRONT ST
Practice Address - Street 2:
Practice Address - City:RICHLANDS
Practice Address - State:VA
Practice Address - Zip Code:24641-2099
Practice Address - Country:US
Practice Address - Phone:276-596-6000
Practice Address - Fax:276-596-6009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007684OtherWELLPOINT VA/BLUE CROSS