Provider Demographics
NPI:1013148816
Name:CMH EAR, NOSE, THROAT & ALLERGY LLC
Entity Type:Organization
Organization Name:CMH EAR, NOSE, THROAT & ALLERGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TATUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-774-2400
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:SOUTH HILL
Mailing Address - State:VA
Mailing Address - Zip Code:23970-0127
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:606 N THOMAS ST
Practice Address - Street 2:
Practice Address - City:SOUTH HILL
Practice Address - State:VA
Practice Address - Zip Code:23970-1422
Practice Address - Country:US
Practice Address - Phone:434-774-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY MEMORIAL HEALTHCENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty