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General NPI Number Information
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NPI Number | 1447710363
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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 | 03/25/2019
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 436 HOSPITAL DRIVE SUITE 230
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City | LINVILLE
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State | NC
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Zip | 28646-0436
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Country | US
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Telephone | 828-737-7711
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Fax | 828-737-7713
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Provider Business Mailing Address
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Address Line | 434 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 | 828-737-7000
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Fax | 828-262-4103
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Authorized Official
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Title or Position | SR. VP MEDICAL STAFF RELATIONS
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Name | MARY ETTA LONG
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Credential |
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Telephone | 828-262-4133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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