Healthcare Provider Details

I. General information

NPI: 1750433389
Provider Name (Legal Business Name): SMYTH COUNTY COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 11/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1152 SNIDER ST
MARION VA
24354-4216
US

IV. Provider business mailing address

311 PRINCETON RD
JOHNSON CITY TN
37601-2026
US

V. Phone/Fax

Practice location:
  • Phone: 276-782-9696
  • Fax: 276-782-9886
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateTN

VIII. Authorized Official

Name: MARY LYNN KRUTAK
Title or Position: SVP/CFO
Credential:
Phone: 423-302-3374