Provider Demographics
NPI:1609862192
Name:HUGH CHATHAM MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:HUGH CHATHAM MEMORIAL HOSPITAL
Other - Org Name:YADKIN VALLEY HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIPPEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-527-7216
Mailing Address - Street 1:560 WINSTON RD STE B
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28642-2217
Mailing Address - Country:US
Mailing Address - Phone:336-526-6460
Mailing Address - Fax:336-526-6468
Practice Address - Street 1:560 WINSTON RD STE B
Practice Address - Street 2:
Practice Address - City:JONESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28642-2217
Practice Address - Country:US
Practice Address - Phone:336-526-6460
Practice Address - Fax:336-526-6468
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUGH CHATHAM MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-21
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0346251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3417080Medicaid
NC3417080Medicaid