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NPI 1285685727

NPI 1285685727 : DICKENSON COMMUNITY HOSPITAL, INC. : CLINTWOOD, VA

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General NPI Number Information
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    NPI Number           |    1285685727
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    Entity Type          |    Organization 
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    Legal Business Name  |    DICKENSON COMMUNITY HOSPITAL, INC. 
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Dates
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    Enumeration Date     |    05/12/2006
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    Last Update Date     |    04/16/2024
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Provider Practice Location Address
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    Address Line         |    312 HOSPITAL DR 
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    City                 |    CLINTWOOD
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    State                |    VA
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    Zip                  |    24228-6786
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    Country              |    US
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    Telephone            |    276-926-0300
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    Fax                  |    276-926-0329
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Provider Business Mailing Address
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    Address Line         |    311 PRINCETON RD STE 1 
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    City                 |    JOHNSON CITY
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    State                |    TN
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    Zip                  |    37601-2026
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    Country              |    US
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    Telephone            |    276-926-0300
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    Fax                  |    276-926-0329
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Authorized Official
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    Title or Position    |    EVP/CFO
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    Name                 |     SHANE EDWIN HILTON 
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    Credential           |    
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    Telephone            |    423-302-3467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    282NC0060X
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    Taxonomy Name        |    Critical Access Hospital
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    License Number       |    H1918
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    License Number State |    VA
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