Provider Demographics
NPI:1376549261
Name:SMYTH COUNTY COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:SMYTH COUNTY COMMUNITY HOSPITAL
Other - Org Name:SMYTH REGIONAL OB-GYN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDY
Authorized Official - Middle Name:P
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-782-1240
Mailing Address - Street 1:1070 TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354
Mailing Address - Country:US
Mailing Address - Phone:276-781-2225
Mailing Address - Fax:276-783-8843
Practice Address - Street 1:1070 TERRACE DR
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354
Practice Address - Country:US
Practice Address - Phone:276-781-2225
Practice Address - Fax:276-783-8843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-24
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAH1902207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA139707OtherANTHEM
VAC09142Medicare Oscar/Certification