Provider Demographics
NPI:1184620072
Name:SMYTH COUNTY COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:SMYTH COUNTY COMMUNITY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDY
Authorized Official - Middle Name:P
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-782-1240
Mailing Address - Street 1:1118 SNIDER STREET
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354
Mailing Address - Country:US
Mailing Address - Phone:276-783-5148
Mailing Address - Fax:276-783-6716
Practice Address - Street 1:1118 SNIDER STREET
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354
Practice Address - Country:US
Practice Address - Phone:276-783-5148
Practice Address - Fax:276-783-6716
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SMYTH COUNTY COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-24
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAH1902207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA202760OtherBLACK LUNG
VA181312OtherANTHEM
VADB9968OtherRAILROAD MEDICARE
VAC09148Medicare PIN