Healthcare Provider Details
I. General information
NPI: 1184620072
Provider Name (Legal Business Name): SMYTH COUNTY COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/24/2005
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1118 SNIDER STREET
MARION VA
24354
US
IV. Provider business mailing address
1118 SNIDER STREET
MARION VA
24354
US
V. Phone/Fax
- Phone: 276-783-5148
- Fax: 276-783-6716
- Phone: 276-783-5148
- Fax: 276-783-6716
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | H1902 |
| License Number State | VA |
VIII. Authorized Official
Name: MRS.
LINDY
P.
WHITE
Title or Position: CEO
Credential:
Phone: 276-782-1240