1225208705 NPI number — DANVILLE REGIONAL MEDICAL CENTER, LLC

Table of content: (NPI 1225208705)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225208705 NPI number — DANVILLE REGIONAL MEDICAL CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DANVILLE REGIONAL MEDICAL CENTER, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SOVAH HEALTH MARTINSVILLE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225208705
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/23/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
330 SEVEN SPRINGS WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-4536
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-920-7000
Provider Business Mailing Address Fax Number:
615-920-8913

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
320 HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARTINSVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24112-1900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
276-666-7647
Provider Business Practice Location Address Fax Number:
276-666-0363
Provider Enumeration Date:
03/11/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DILLON
Authorized Official First Name:
TERRANCE
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSISTANT SECRETARY
Authorized Official Telephone Number:
502-596-7220

Provider Taxonomy Codes

  • Taxonomy code: 207T00000X , with the licence number:  101230513 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207T00000X , with the licence number: 101044867 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207T00000X , with the licence number: 101031630 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084N0600X , with the licence number: 101053228 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 101042317 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 101057668 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 007118147 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1841217932 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1942269766 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 007118121 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1851382873 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 007313063 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1073501383 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 004900791 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 007118139 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 007313055 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 007118155 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1669462859 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1881684074 . This is a "NPI" identifier . This identifiers is of the category "OTHER".




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