MEDICARE: LEWIS-GALE MEDICAL CENTER, LLC

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	261QE0002X	Emergency Care Clinic/Center

General Provider Information

NPI Number	:	1962921239
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEWIS-GALE MEDICAL CENTER, LLC

Provider Business Mailing Address
First Line	:	2706 OGDEN RD
Second Line	:
City	:	CAVE SPRING
State	:	VA
Zip	:	24018-0600
Country	:	US
Telephone Number	:	540-776-4000
Fax Number	:	540-776-4785

Provider Business Practice Location Address
First Line	:	2706 OGDEN RD
Second Line	:
City	:	CAVE SPRING
State	:	VA
Zip	:	24018-0600
Country	:	US
Telephone Number	:	540-776-4000
Fax Number	:	540-776-4785

Authorized Official
Title or Position	:	CFO
Name	:	ANGELA H. REYNOLDS
Credential	:
Telephone Number	:	540-776-4125

Provider Enumeration Date	:	09/18/2017
Last Update Date	:	07/21/2022

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