Provider Demographics
NPI:1356318968
Name:ALLEGHANY COUNTY MEMORIAL HOSPITAL INC
Entity Type:Organization
Organization Name:ALLEGHANY COUNTY MEMORIAL HOSPITAL INC
Other - Org Name:ALLEGHANY HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL STAFF COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARLA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-372-3127
Mailing Address - Street 1:233 DOCTORS ST
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NC
Mailing Address - Zip Code:28675
Mailing Address - Country:US
Mailing Address - Phone:336-372-5511
Mailing Address - Fax:336-372-6563
Practice Address - Street 1:233 DOCTORS ST
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NC
Practice Address - Zip Code:28675
Practice Address - Country:US
Practice Address - Phone:336-372-5511
Practice Address - Fax:336-372-6563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-02
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH0108282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC00015OtherNC BLUE CROSS HOSPITAL
VA010194377Medicaid
NC660HOSOtherPARTNERS MCR CHOICE
NC07692OtherNC BCBS PROFESSIONAL
NC00971OtherNC BCBS SWING BED
NC235003OtherCIGNA MEDICARE
VA442042OtherANTHEM BCBS OF VA
FL091278600Medicaid
NC152167500OtherACS
VA009810234Medicaid
NC3401320Medicaid
NC235003OtherCIGNA MEDICARE
VA009810234Medicaid