Provider Demographics
NPI:1881690550
Name:BUCHANAN GENERAL HOSPITAL INC.
Entity Type:Organization
Organization Name:BUCHANAN GENERAL HOSPITAL INC.
Other - Org Name:BUCHANAN GENERAL HOSPITAL HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:RUCHTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-935-1000
Mailing Address - Street 1:1535 SLATE CREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:GRUNDY
Mailing Address - State:VA
Mailing Address - Zip Code:24614-9611
Mailing Address - Country:US
Mailing Address - Phone:276-935-1509
Mailing Address - Fax:276-935-1512
Practice Address - Street 1:1535 SLATE CREEK ROAD
Practice Address - Street 2:
Practice Address - City:GRUNDY
Practice Address - State:VA
Practice Address - Zip Code:24614-9611
Practice Address - Country:US
Practice Address - Phone:276-935-1509
Practice Address - Fax:276-935-1512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-27
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVA497020251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004970209Medicaid
VA007500OtherBCBS PROVIDER NUMBER
070932800OtherF BLACK LUNG
VA070932800OtherFEDERAL BLACK LUNG NUMBER
070932800OtherF BLACK LUNG
VA007500OtherBCBS PROVIDER NUMBER