1225036346 NPI number — BUCHANAN GENERAL HOSPITAL, INC

Table of content: (NPI 1225036346)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225036346 NPI number — BUCHANAN GENERAL HOSPITAL, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BUCHANAN GENERAL HOSPITAL, INC
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:
Provider Other Organization Name Type Code:
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:
1225036346
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/04/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1535 SLATE CREEK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRUNDY
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24614-6974
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
276-935-1000
Provider Business Mailing Address Fax Number:
276-935-1538

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1535 SLATE CREEK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRUNDY
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24614-6974
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
276-935-1000
Provider Business Practice Location Address Fax Number:
276-935-1538
Provider Enumeration Date:
07/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
RUCHTI
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
D
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
276-935-1000

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  H1835 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000302044 . This is a "MTN STATE BCBS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 007614 . This is a "BLUE CROSS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4900127 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0001785000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 148853700 . This is a "FEDERAL BLACKLUNG" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 824666 . This is a "ARIZONA MEDICAID" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 01660521 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4901274 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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