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General NPI Number Information
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NPI Number | 1053510081
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Entity Type | Organization
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Legal Business Name | CHARLES A CANNON JR MEMORIAL HOSPITAL INC.
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 436 HOSPITAL DRIVE
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City | LINVILLE
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State | NC
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Zip | 28646
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Country | US
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Telephone | 828-737-7865
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Fax | 828-737-7867
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Provider Business Mailing Address
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Address Line | PO BOX 459
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City | LINVILLE
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State | NC
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Zip | 28646-0459
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Country | US
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Telephone | 828-737-7865
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Fax | 828-737-7867
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MICHAEL A STHAY
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Credential | M.D.
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Telephone | 828-737-7865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 20060073
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License Number State | NC
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