1710970918 NPI number — CARILION FRANKLIN MEMORIAL HOSPITAL

Table of content: (NPI 1710970918)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710970918 NPI number — CARILION FRANKLIN MEMORIAL HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARILION FRANKLIN MEMORIAL HOSPITAL
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:
1710970918
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/24/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
213 S JEFFERSON ST STE 1006
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROANOKE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24011-1713
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-483-5277
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
180 FLOYD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCKY MOUNT
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24151-1318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-483-5277
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GRISETTI
Authorized Official First Name:
NICOLE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF OPERATIONAL SUPPORT
Authorized Official Telephone Number:
540-224-5352

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  H 1836 , 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: 0175933000 . This is a "WEST VIRGINIA MEDICAID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 036198700 . This is a "BLACK LUNG" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 354360000 . This is a "MAGELLAN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 007642 . This is a "ANTHEM HOSPITAL" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4900898 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 442193 . This is a "ANTHEM OFF CAMPUS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 0000892 . This is a "SLH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 147119 . This is a "SOUTHERN HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com