Provider Demographics
NPI:1831330075
Name:JOHNSTON MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:JOHNSTON MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:RENNIE
Authorized Official - Middle Name:B
Authorized Official - Last Name:ATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:276-676-7147
Mailing Address - Street 1:351 COURT STREET NE
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210
Mailing Address - Country:US
Mailing Address - Phone:276-676-7147
Mailing Address - Fax:
Practice Address - Street 1:351 COURT STREET NE
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210
Practice Address - Country:US
Practice Address - Phone:276-676-7241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0201001156OtherCOMMONWEALTH OF VIRGINIA BOARD OF PHARMACY PERMIT