Provider Demographics
NPI:1568600047
Name:HUGH CHATHAM MEMORIAL HOSPITAL, INC
Entity Type:Organization
Organization Name:HUGH CHATHAM MEMORIAL HOSPITAL, INC
Other - Org Name:SOUTHWEST VIRGINIA ORTHOPEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:TRIPPEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-527-7216
Mailing Address - Street 1:502 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-3918
Mailing Address - Country:US
Mailing Address - Phone:276-236-9393
Mailing Address - Fax:276-236-2882
Practice Address - Street 1:502 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-3918
Practice Address - Country:US
Practice Address - Phone:276-236-9393
Practice Address - Fax:276-236-2882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-22
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB19131Medicare UPIN