Provider Demographics
NPI:1295869857
Name:HUGH CHATHAM MEMORIAL HOSPITAL, INC.
Entity type:Organization
Organization Name:HUGH CHATHAM MEMORIAL HOSPITAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:PENNINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-527-7312
Mailing Address - Street 1:PO BOX 560
Mailing Address - Street 2:
Mailing Address - City:ELKIN
Mailing Address - State:NC
Mailing Address - Zip Code:28621-0560
Mailing Address - Country:US
Mailing Address - Phone:336-527-7000
Mailing Address - Fax:336-526-6056
Practice Address - Street 1:180 PARKWOOD DR
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-2430
Practice Address - Country:US
Practice Address - Phone:336-527-7000
Practice Address - Fax:336-526-6056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH0049273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC00111OtherBLUE CROSS ACUTE REHAB
NC900HOSOtherPARTNERS ACUTE REHAB
NC3400097Medicaid
NC900HOSOtherPARTNERS ACUTE REHAB
NC00111OtherBLUE CROSS ACUTE REHAB