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General NPI Number Information
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NPI Number | 1073164539
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Entity Type | Organization
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Legal Business Name | SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS INC
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Dates
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Enumeration Date | 09/26/2019
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Last Update Date | 06/07/2021
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Provider Practice Location Address
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Address Line | 416 E MAIN ST RM 2
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City | MARION
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State | VA
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Zip | 24354-3318
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Country | US
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Telephone | 276-783-8185
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 297
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City | MEADOWVIEW
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State | VA
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Zip | 24361-0297
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Country | US
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Telephone | 276-496-4492
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Fax | 276-695-4001
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Authorized Official
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Title or Position | CEO
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Name | JOSEPH BRYAN HAYNES
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Credential |
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Telephone | 276-496-4492
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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