MEDICARE: BUCHANAN GENERAL HOSPITAL INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	VA497020	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	007500	OTHER	VA	BCBS PROVIDER NUMBER
3	070932800	OTHER		F BLACK LUNG
4	070932800	OTHER	VA	FEDERAL BLACK LUNG NUMBER

General Provider Information

NPI Number	:	1881690550
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUCHANAN GENERAL HOSPITAL INC.

Provider Business Mailing Address
First Line	:	1535 SLATE CREEK ROAD
Second Line	:
City	:	GRUNDY
State	:	VA
Zip	:	24614-9611
Country	:	US
Telephone Number	:	276-935-1509
Fax Number	:	276-935-1512

Provider Business Practice Location Address
First Line	:	1535 SLATE CREEK ROAD
Second Line	:
City	:	GRUNDY
State	:	VA
Zip	:	24614-9611
Country	:	US
Telephone Number	:	276-935-1509
Fax Number	:	276-935-1512

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. ROBERT D. RUCHTI
Credential	:
Telephone Number	:	276-935-1000

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	01/02/2014

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