Healthcare Provider Details

I. General information

NPI: 1043387939
Provider Name (Legal Business Name): PHC-MARTINSVILLE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 HOSPITAL DR
MARTINSVILLE VA
24112-1900
US

IV. Provider business mailing address

103 POWELL CT STE. 200
BRENTWOOD TN
37027-5079
US

V. Phone/Fax

Practice location:
  • Phone: 276-666-7200
  • Fax: 276-666-7600
Mailing address:
  • Phone: 615-372-8500
  • Fax: 615-372-8572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM M. GRACEY
Title or Position: COO
Credential:
Phone: 615-372-8500