1881690550 NPI number — BUCHANAN GENERAL HOSPITAL INC.

Table of content: (NPI 1881690550)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881690550 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:
6
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:
1881690550
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/02/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1535 SLATE CREEK ROAD
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:
24614-9611
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
276-935-1509
Provider Business Mailing Address Fax Number:
276-935-1512

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1535 SLATE CREEK ROAD
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:
24614-9611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
276-935-1509
Provider Business Practice Location Address Fax Number:
276-935-1512
Provider Enumeration Date:
06/27/2005

Additional Information

Authorized Official

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

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  VA497020 , 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: 004970209 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 007500 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 070932800 . This is a "F BLACK LUNG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 070932800 . This is a "FEDERAL BLACK LUNG NUMBER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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