Provider Demographics
NPI:1609934413
Name:CHARLES A CANNON JR MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:CHARLES A CANNON JR MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT FINANCIAL SERVICES DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:BARRIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-737-7011
Mailing Address - Street 1:PO BOX 787
Mailing Address - Street 2:
Mailing Address - City:LINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28646-0787
Mailing Address - Country:US
Mailing Address - Phone:828-737-7000
Mailing Address - Fax:828-737-7015
Practice Address - Street 1:434 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:LINVILLE
Practice Address - State:NC
Practice Address - Zip Code:28646-0787
Practice Address - Country:US
Practice Address - Phone:828-737-7000
Practice Address - Fax:828-737-7015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH0037282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0340005OtherTN MEDICAID ACUTE CARE
NC00103OtherNC BLUE CROSS ACUTE CARE
TN6065Medicaid
NC3400005Medicaid
NC290780OtherMAMSI ACUTE CARE PROV
NC5070877OtherUNITED HEALTHCARE ACUTE #
TN0340005OtherTN MEDICAID ACUTE CARE
NC3400005Medicaid