Healthcare Provider Details

I. General information

NPI: 1861001539
Provider Name (Legal Business Name): HALIFAX REGIONAL HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2020
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

946 N MAIN ST
CHASE CITY VA
23924-1139
US

IV. Provider business mailing address

2204 WILBORN AVE
SOUTH BOSTON VA
24592-1645
US

V. Phone/Fax

Practice location:
  • Phone: 434-372-5141
  • Fax:
Mailing address:
  • Phone: 757-455-7395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MELINDA SUMMERLIN HANCOCK
Title or Position: CFO
Credential:
Phone: 757-455-7458